Agrawal, VaibhavDinh, Paul C., Jr.Fung, ChunkitMonahan, Patrick O.Althouse, Sandra K.Norton, KelliCary, ClintEinhorn, LawrenceFossa, Sophie D.Adra, NabilTravis, Lois B.2020-01-232020-01-232019-10Agrawal, V., Dinh, P. C., Fung, C., Monahan, P. O., Althouse, S. K., Norton, K., … Travis, L. B. (2019). Adverse Health Outcomes among U.S. Testicular Cancer Survivors after Cisplatin-Based Chemotherapy vs. Surgical Management. JNCI Cancer Spectrum. https://doi.org/10.1093/jncics/pkz079https://hdl.handle.net/1805/21895We evaluated for the first time adverse health outcomes (AHOs) among U.S. testicular cancer survivors (TCS) given chemotherapy (n = 381) vs. surgery-only patients (n = 98) managed at a single institution, accounting for non-treatment-related risk factors to delineate chemotherapy’s impact. Chemotherapy consisted largely of bleomycin-etoposide-cisplatin (BEP) administered in 3 or 4 cycles (BEPX3, n = 235; BEPX4, n = 82). Incidence of ≥ 3 AHOs was lowest in surgery-only TCS and increased with BEPX3, BEPX4 and other cisplatin-based regimens (12.2%, 40.8%, 52.5%, 54.8%; P<0.0001). Multivariate modeling assessed associations of risk factors and treatment with hearing impairment, tinnitus, peripheral neuropathy, and Raynaud phenomenon. Risk for each AHO significantly increased with both increasing chemotherapy burden (P < 0.0001) and selected modifiable risk factors (P < 0.05): hypertension (OR = 2.40) and noise exposure (OR ≥ 2.3) for hearing impairment; noise exposure for tinnitus (OR ≥ 1.69); peripheral vascular disease for neuropathy (OR = 8.72), and current smoking for Raynaud phenomenon (OR = 2.41). Clinicians should manage modifiable risk factors for AHOs among TCS.enAttribution 4.0 Internationalperipheral neuropathytesticular cancersmokingArticle