Table 1.
Clinical and Sociodemographic Characteristics, Health Behaviors, and Physical Examination Findings for 1,410 Survivors of Cisplatin-Treated Germ-Cell Tumors (GCT) with Comprehensive Audiometric Assessments
| Characteristic | No. (%) |
|---|---|
| Clinical characteristic | |
| Age at GCT diagnosis, years | |
| Median (range) | 31 (10-60) |
| <20 | 95 (6.7) |
| 20-29 | 535 (37.9) |
| 30-39 | 465 (33.0) |
| ≥ 40 | 315 (22.3) |
| Age at audiometry, years | |
| Median (range) | 37 (18-74) |
| <20 | 6 (0.4) |
| 20-29 | 298 (21.1) |
| 30-39 | 501 (35.5) |
| 40-49 | 347 (24.6) |
| 50-59 | 214 (15.2) |
| ≥ 60 | 44 (3.1) |
| Calendar year of GCT diagnosis a | |
| Before 2000 | 141 (10.1) |
| 2000-2009 | 431 (30.8) |
| 2010-2017 | 827 (59.1) |
| Histologic type b | |
| Seminoma | 380 (27.2) |
| Nonseminoma or mixed GCT | 1007 (72.0) |
| GCT, not otherwise specified | 12 (0.9) |
| Site of GCT c | |
| Testis | 1256 (89.8) |
| Extragonadal | 143 (10.2) |
| Cisplatin-based chemotherapy d | |
| BEP e | 792 (56.2) |
| EP f | 514 (36.5) |
| Otder g | 104 (7.4) |
| Cumulative dose of cisplatin, mg/m2 h | |
| Median (range) | 400 (100-1402.8) |
| <300 | 73 (5.2) |
| 300 | 527 (37.4) |
| 301-399 | 58 (4.1) |
| 400 | 685 (48.7) |
| >400 | 65 (4.6) |
| Time since completion of chemotderapy, years i | |
| Median (range) | 3.1 (0.5-31.9) |
| <2 | 537 (38.5) |
| 2-<5 | 350 (25.1) |
| 5-<10 | 250 (17.9) |
| ≥ 10 | 258 (18.5) |
| Sociodemographic characteristic | |
| Race j | |
| White | 1184 (87.4) |
| African American | 12 (0.9) |
| Asian | 63 (4.7) |
| Otder | 96 (7.1) |
| Education k | |
| High school or less | 146 (10.5) |
| After high school but not college graduate | 308 (22.1) |
| College or university graduate | 602 (43.2) |
| Post-graduate | 338 (24.3) |
| Employment status l | |
| Unemployed | 96 (7.0) |
| Employed | 1224 (88.9) |
| Retired | 27 (2.0) |
| On disability leave | 30 (2.2) |
| Healtd behavior | |
| Smoking status m | |
| Never | 854 (61.3) |
| Former | 453 (32.5) |
| Current | 87 (6.2) |
| Average no. alcoholic drinks in past year n | |
| Rarely or never | 266 (19.1) |
| ≤ 4 per week | 634 (45.6) |
| 5 per week to 1 per day | 322 (23.2) |
| ≥2 daily | 169 (12.2) |
| Physical activity (total MET-hours/week) quartiles o | |
| Quartile 1, Median (range) | 4.28 (0-10.23) |
| Quartile 2, Median (range) | 17.5(10.24-26.0) |
| Quartile 3, Median (range) | 34.5 (26.1-48.4) |
| Quartile 4, Median (range) | 72.9 (48.5-300) |
| Engage in vigorous physical activity (≥ 6 METs) p | |
| Yes | 941 (67.5) |
| No | 453 (32.5) |
| Physical examination finding | |
| Body mass index (kg/m2) q | |
| Median (range) | 27.3 (18.0-66.6) |
| < 25 (normal) | 399 (28.5) |
| 25-29 (overweight) | 592 (42.4) |
| ≥ 30 (obese/morbidly obese) | 407 (29.1) |
| Waist circumference, cm r | |
| Median (range) | 94 (62-190) |
| <102 | 980 (71.1) |
| ≥ 102 | 399 (28.9) |
Abbreviations: BEP, bleomycin, etoposide, and cisplatin; BMI, body mass index; CBCT, cisplatin-based chemotherapy; EP, etoposide and cisplatin; GCT, germ cell tumor; MET, metabolic equivalent task; VeIP, vinblastine, ifosfamide, and cisplatin; VIP, etoposide, ifosfamide, and cisplatin.
Calendar year of diagnosis was not available for 11 participants.
Histologic type was not available for 11 participants.
Germ cell tumor site was not available for 11 participants.
Thirty-eight (2.7%), 577 (41%), 758 (53.8%), and 36 (2.6%) participants received ≤ two, three, four, and five or more cycles of CBCT, respectively. Number of cycles was not available for one participant.
Includes 173 (21.8%) participants with modification of dosing and schedules of BEP. The remaining 619 participants (78.2%) received the standard dosing and standard BEP schedule: each chemotherapy cycle consisted of bleomycin, 30,000 IU days 1, 8, and 15; etoposide 100 mg/m2 days 1 through 5; and cisplatin 20 mg/m2 days 1 through 5. In addition, 541 (68.3%) and 223 (28.2%) participants received three and four cycles of BEP, respectively. Median cumulative cisplatin doses for the BEP group were 300 mg/m2 (range, 100 to 800 mg/m2).
Includes 205 (39.9%) participants with modification of dosing and schedules of EP. The remaining 309 participants (60.1%) received the standard dosing and standard EP schedule: each chemotherapy cycle consisted of etoposide 100 mg/m2 days 1 through 5 and cisplatin 20 mg/m2 days 1 through 5. In addition, 456 (88.7%) participants received four cycles of EP. The median cumulative cisplatin doses for the EP group were 400 mg/m2 (range, 200 to 1402.8 mg/m2).
Of 104 participants, 55 received VIP, 32 received cisplatin and ifosfamide; 6 received cisplatin, bleomycin, etoposide, and ifosfamide; one received VeIP. For the remaining 10, other combinations of CBCT were applied.
Cisplatin dose information was not available for 2 participants.
Information on time since completion of chemotherapy was not available for 15 participants.
Race not stated for 55 participants.
Educational status not stated for 16 participants.
Employment status not stated for 33 participants.
Smoking status not stated for 16 participants.
Average no. of alcoholic drinks in past year not stated for 19 participants.
Physical activity was assessed in this study based on a validated questionnaire (Ainsworth et al. 2011; Chasan-Taber et al. 1996; Taylor et al. 1978). Participants were asked about the type of physical activity (walking; jogging (>10 min/mile); running (≤10 min/mile); bicycling; aerobic exercise; lower intensity exercise such as yoga, stretching, or toning; tennis, squash, or racquetball; lap swimming; weight lifting or stretch swimming) and average time per week (during the past year) spent at each of these activities. Participants were also asked about the number of flights of stairs they climb daily. A MET value was assigned to each physical activity based on its energy cost. Walking pace was used to calculate MET-hours/week from walking (Ainsworth et al. 1993). Physical activity (total MET-hours/week) was derived from reported hours per week of each physical activity plus the reported number of climbed flights of stairs per day (Curhan et al. 2013). Physical activity information was not provided by 16 participants.
Vigorous physical activity was defined based on activities with MET value ≥ 6 (Ainsworth et al. 2011). Physical activity information was not provided by 16 participants.
BMI not available for 12 participants. Among 407 participants with BM I≥ 30, 358 and 49 participants had a BMI of 30-39 kg/m2 (obese) and ≥ 40 kg/m2 (morbidly obese), respectively.
Abdominal obesity was defined as waist circumference ≥ 102 for men (D. Kim et al. 2019). Waist circumference not available for 31 participants.