AUTHOR=Cazzaniga Walter , Kinsella Janette , Pearce Adam Kieran , Moghul Masood , Fox Louis , Van Hemelrijck Mieke , Reid Alison , Huddart Robert , Nicol David 

TITLE=Understanding the health-related quality of life and treatment-related side-effects in patients who have been in remission from testicular cancer for 12–24 months

JOURNAL=Frontiers in Urology

VOLUME=Volume 3 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/urology/articles/10.3389/fruro.2023.1174626

DOI=10.3389/fruro.2023.1174626

ISSN=2673-9828

ABSTRACT=INTRODUCTION: Despite the excellent long-term prognosis after treatment for testicular cancer (Tca), therapy-related side effects can be persistent and severe. The aim of this study is to determine the nature and prevalence of post-treatment symptoms and impact of Health-related quality of life (HRQoL) in Tca patients, 12 to 24 months after treatment.
MATERIALS AND METHODS: Cross-sectional, single center study. All patients (aged 18 and over) who had completed Tca treatment 12-24 months previously and had no evidence of disease recurrence were considered eligible. Participants were stratified into four groups: 1) Orchidectomy only; 2) Orchidectomy and single dose adjuvant carboplatin; 3) Multi-agent induction chemotherapy (CBOP-BEP, BEPx3 or x4, Epx4 regimens); 4) Post-chemo Retroperitoneal lymph node dissection (PC-RPLND). Eligible patients were asked to complete the EQ-5D-5L questionnaire and the EORTC QLQ-TC26 questionnaire. We performed a thematic analysis of free-text commentary, to evaluate the sensitivity of PROMs used across the treatment groups. Descriptive results are reported. For categorical variables, numbers and percentages were used and for continuous variables median and IQR.
RESULTS: The EQ-5D-5L questionnaire showed that patients treated with Orchidectomy only and Orchidectomy and adjuvant carboplatin experienced only minor physical medium to long-term side-effects; In contrast, more intensive treatment regimens such as multi-agent chemotherapy or PC-RPLND, were associated with a higher burden of medium to long-term side-effects. Similar results were obtained with the EORTC QLQ-TC26 questionnaire. 
CONCLUSIONS: This study reports the medium-to long-term HRQoL and side effects of Tca treatments, using both EQ-5D-5L and EORTC QLQ-TC26 questionnaires and defines unasked questions from a patient perspective in relation to supportive care needs following Tca treatment. This information will help clinicians to better understand treatment’s consequences and therefore provide a better patient counseling before treatment.