Unusually Located Stroke After Chemotherapy in Testicular Germ Cell Tumors

Martínez, Braulio Alexander; Correa, Edgar Patricio

doi:10.1177/2324709615590198

Cited by 3 publications

(1 citation statement)

References 42 publications

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“…Interestingly, Fung et al recently observed increased CVD mortality only during the first year of follow‐up (based on only 6 cardiac deaths and 5 cerebrovascular disease deaths), although the median follow‐up was only 6.5 years after chemotherapy in their study. Some case reports have described severe acute myocardial infarction or stroke shortly after chemotherapy in TC survivors, although these events are rare and usually not fatal. Differences in the underlying CVD risk factors, lifestyles, and prophylactic use of low‐molecular‐weight heparin to prevent platinum‐associated thromboembolic events may underlie these heterogeneous findings with respect to CVD mortality …”

Section: Discussionmentioning

confidence: 99%

Platinum exposure and cause‐specific mortality among patients with testicular cancer

Groot

Leeuwen

Lubberts

et al. 2019

Cancer

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BACKGROUND: Although testicular cancer (TC) treatment has been associated with severe late morbidities, including second malignant neoplasms (SMNs) and ischemic heart disease (IHD), cause-specific excess mortality has been rarely studied among patients treated in the platinum era. METHODS: In a large, multicenter cohort including 6042 patients with TC treated between 1976 and 2006, causespecific mortality was compared with general population mortality rates. Associations with treatment were assessed with proportional hazards analysis. RESULTS: With a median follow-up of 17.6 years, 800 patients died; 40.3% of these patients died because of TC. The cumulative mortality was 9.6% (95% confidence interval [CI], 8.5%-10.7%) 25 years after TC treatment. In comparison with general population mortality rates, patients with nonseminoma experienced 2.0 to 11.6 times elevated mortality from lung, stomach, pancreatic, rectal, and kidney cancers, soft-tissue sarcomas, and leukemia; 1.9-fold increased mortality (95% CI, 1.3-2.8) from IHD; and 3.9-fold increased mortality (95% CI, 1.5-8.4) from pneumonia. Seminoma patients experienced 2.5 to 4.6 times increased mortality from stomach, pancreatic, bladder cancer and leukemia. Radiotherapy and chemotherapy were associated with 2.1 (95% CI, 1.8-2.5) and 2.5 times higher SMN mortality (95% CI, 2.0-3.1), respectively, in comparison with the general population. In a multivariable analysis, patients treated with platinum-containing chemotherapy had a 2.5-fold increased hazard ratio (HR; 95% CI, 1.8-3.5) for SMN mortality in comparison with patients without platinum-containing chemotherapy. The HR for SMN mortality increased 0.29 (95% CI, 0.19-0.39) per 100 mg/m 2 platinum dose administered (P trend < .001). IHD mortality was increased 2.1-fold (95% CI, 1.5-4.2) after platinum-containing chemotherapy in comparison with patients without platinum exposure. CONCLUSIONS: Platinum-containing chemotherapy is associated with a dosedependent increase in the risk of SMN mortality. Cancer 2020;126:628-639.

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Section: Discussionmentioning

confidence: 99%

Platinum exposure and cause‐specific mortality among patients with testicular cancer

Groot

Leeuwen

Lubberts

et al. 2019

Cancer

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Bleomycin/cisplatin

2017

Reactions Weekly

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Internal carotid artery occlusion and stroke as a complication of cisplatin-based chemotherapy for metastatic testicular germ cell tumour

Cerrud‐Rodriguez¹,

Quinteros²,

Azam³

2017

BMJ Case Reports

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Testicular tumours are the most common tumours in young men. Germ cell tumours (GCTs) account for 95% of all testicular cancers, and the non-seminomatous type (NSGCT) accounts for 50% of all GCTs. Cisplatin-based chemotherapy is curative in up to 90% of patients, but it is not without its inherent risks. Ischaemic stroke is a very uncommon, but severe complication of cisplatin-based chemotherapy. Strokes in young patients cause a disproportionately large economic impact by leaving victims disabled during their most productive years and strains the healthcare system with expensive hospital stays. We present a case of a young male patient with past medical history of metastatic NSGCT with the sudden onset of dysarthria, left hemiplegia and ipsilateral hemisensory loss 3 days after receiving cisplatin-based chemotherapy. Subsequent studies revealed a stroke involving the right middle cerebral artery territory secondary to an acute right internal carotid occlusion.

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Unusually Located Stroke After Chemotherapy in Testicular Germ Cell Tumors

Cited by 3 publications

References 42 publications

Platinum exposure and cause‐specific mortality among patients with testicular cancer

Platinum exposure and cause‐specific mortality among patients with testicular cancer

Bleomycin/cisplatin

Internal carotid artery occlusion and stroke as a complication of cisplatin-based chemotherapy for metastatic testicular germ cell tumour

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