Cognitive function in long-term testicular cancer survivors: impact of modifiable factors

JNCI Cancer Spectr. 2024 Sep 2;8(5):pkae068. doi: 10.1093/jncics/pkae068.

Abstract

No study has comprehensively examined associated factors (adverse health outcomes, health behaviors, and demographics) affecting cognitive function in long-term testicular cancer survivors (TC survivors). TC survivors given cisplatin-based chemotherapy completed comprehensive, validated surveys, including those that assessed cognition. Medical record abstraction provided cancer and treatment history. Multivariable logistic regression examined relationships between potential associated factors and cognitive impairment. Among 678 TC survivors (median age = 46; interquartile range [IQR] = 38-54); median time since chemotherapy = 10.9 years, IQR = 7.9-15.9), 13.7% reported cognitive dysfunction. Hearing loss (odds ratio [OR] = 2.02; P = .040), neuropathic pain (OR = 2.06; P = .028), fatigue (OR = 6.11; P < .001), and anxiety/depression (OR = 1.96; P = .029) were associated with cognitive impairment in multivariable analyses. Being on disability (OR = 9.57; P = .002) or retired (OR = 3.64; P = .029) were also associated with cognitive decline. Factors associated with impaired cognition identify TC survivors requiring closer monitoring, counseling, and focused interventions. Hearing loss, neuropathic pain, fatigue, and anxiety/depression constitute potential targets for prevention or reduction of cognitive impairment in long-term TC survivors.

MeSH terms

  • Adult
  • Antineoplastic Agents / adverse effects
  • Anxiety* / etiology
  • Cancer Survivors* / psychology
  • Cancer Survivors* / statistics & numerical data
  • Cisplatin* / administration & dosage
  • Cisplatin* / adverse effects
  • Cognition*
  • Cognitive Dysfunction* / etiology
  • Depression* / etiology
  • Disabled Persons / psychology
  • Disabled Persons / statistics & numerical data
  • Fatigue* / etiology
  • Hearing Loss* / etiology
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Neuralgia* / etiology
  • Neuralgia* / psychology
  • Risk Factors
  • Testicular Neoplasms* / complications
  • Testicular Neoplasms* / psychology
  • Testicular Neoplasms* / therapy

Substances

  • Cisplatin
  • Antineoplastic Agents