부산대학교 도서관

Background No study has quantified the impact of pain and other adverse health outcomes on global physical and mental health in long-term US testicular cancer survivors or evaluated patient-reported functional impairment due to pain. Methods Testicular cancer survivors given cisplatin-based chemotherapy completed validated surveys, including Patient-Reported Outcomes Measurement Information System v1.2 global physical and mental health, Patient-Reported Outcomes Measurement Information System pain questionnaires, and others. Multivariable linear regression examined relationships between 25 adverse health outcomes with global physical and mental health and pain-interference scores. Adverse health outcomes with a β ^  of more than 2 are clinically important and reported below. Results Among 358 testicular cancer survivors (median age = 46 years, interquartile range [IQR] = 38–53 years; median time since chemotherapy = 10.7 years, IQR = 7.2–16.0 years), median adverse health outcomes number was 5 (IQR = 3–7). A total of 12% testicular cancer survivors had 10 or more adverse health outcomes, and 19% reported chemotherapy-induced neuropathic pain. Increasing adverse health outcome numbers were associated with decreases in physical and mental health (P  <  .0001 each). In multivariable analyses, chemotherapy-induced neuropathic pain (⁠ β ^ = −3.72; P  =  .001), diabetes (⁠ β ^ = −4.41; P  =  .037), obesity (⁠ β ^ = −2.01; P  =  .036), and fatigue (⁠ β ^ = −8.58; P  <  .0001) were associated with worse global mental health, while being married or living as married benefited global mental health (⁠ β ^  = 3.63; P  =  .0006). Risk factors for pain-related functional impairment included lower extremity location (⁠ β ^  = 2.15; P  =  .04) and concomitant peripheral artery disease (⁠ β ^  = 4.68; P  <  .001). Global physical health score reductions were associated with diabetes (⁠ β ^ = −3.81; P  =  .012), balance or equilibrium problems (⁠ β ^ = −3.82; P  =  .003), cognitive dysfunction (⁠ β ^ = −4.43; P  <  .0001), obesity (⁠ β ^ = −3.09; P  <  .0001), peripheral neuropathy score (⁠ β ^ = −2.12; P  <  .0001), and depression (⁠ β ^ = −3.17; P  <  .0001). Conclusions Testicular cancer survivors suffer adverse health outcomes that negatively impact long-term global mental health, global physical health, and pain-related functional status. Clinically important factors associated with worse physical and mental health identify testicular cancer survivors requiring closer monitoring, counseling, and interventions. Chemotherapy-induced neuropathic pain must be addressed, given its detrimental impact on patient-reported functional status and mental health 10 or more years after treatment. [ABSTRACT FROM AUTHOR]