PURPOSE: To assess the effects of the number of cisplatin,etoposide and bleomycin(PEB) cycles on long-term renal function.
PATIENTS AND METHODS: Between 1995 and 2013,157 patients with primary testicular GCTs were treated and 113(72%) received chemotherapy as their primary intervention. Data were retrospectively collected and glomerular filtration rates (GFR) were estimated (eGFR) using the Modification of Diet in Renal Disease formula based on pretreatment and last follow-up visit serum creatinine measurements. Patients treated without chemotherapy (group 1) were compared with those who received cisplatin based chemotherapy(group 2). Group 2 was also divided into three subgroups according to the number of chemotherapy cycles they received: two,three and four or more cycles.
RESULTS: At last follow-up visit the serum creatinine and eGFR values displayed a significant difference between chemotherapy and nonchemotherapy groups.Decrease in median eGFR value was significantly larger in the chemotherapy group compared to nonchemotherapy group(< 0.001). New-onset CKD stage 3 was observed in 19 patients(12,1%) and all these patients were in chemotherapy group.New-onset CKD stage 3 was seen in none,5.9%,13.8%,20.9% of the patients who received no,2,3,4 or more cycles of chemotherapy,respectively. Except the difference between nonchemotherapy group and 2 cycles of chemotherapy group,the differences between groups regarding new-onset CKD stage 3 were statistically significant.
CONCLUSION: Patients with testicular tumors,who received cisplatin based chemotherapy revealed a significant decrease in eGFR and a significant increase in new-onset CKD stage 3 compared to patients who received no chemotherapy. However,in stage I high risk NSGCT patients,choosing 2cycles of PEB chemotherapy did not have a statistically significant effect in these parameters compared to patients who received no chemotherapy.
Written by:
Suer E, Mermerkaya M, Gülpınar O, Afandiyev F, Baltacı S, Türkölmez K, Bedük Y. Are you the author?
University of Ankara, Department of Urology, Ankara, Turkey.
Reference: J Urol. 2013 Jun 10. pii: S0022-5347(13)04572-2.
doi: 10.1016/j.juro.2013.06.009
PubMed Abstract
PMID: 23764076
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