Microalbuminuria, decreased fibrinolysis, and inflammation as early signs of atherosclerosis in long-term survivors of disseminated testicular cancer

Eur J Cancer. 2004 Mar;40(5):701-6. doi: 10.1016/j.ejca.2003.12.012.


Testicular cancer patients have an increased risk for coronary artery disease more than ten years after cisplatin-based chemotherapy. We investigated whether vascular changes, including endothelial dysfunction, are present earlier. Ninety chemotherapy-treated testicular cancer patients (median follow-up of seven years) were compared with 44 patients after orchidectomy only and 47 healthy men. Microalbuminuria was present in 10 (12%) chemotherapy patients, one stage I patient and none of the controls. Chemotherapy patients had higher levels of fibrinogen, C-reactive protein (hs-CRP), von Willebrand factor (vWF), plasminogen activator inhibitor (PAI-1), and tissue-type plasminogen activator (t-PA). Chemotherapy patients with elevated PAI-1 (25/90) showed clustering of cardiovascular risk factors resembling the metabolic syndrome. In conclusion, cured testicular cancer patients showed a high prevalence of microalbuminuria and increased plasma levels of endothelial and inflammatory marker proteins, which might progress to more severe endothelial dysfunction and overt atherosclerosis.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Albuminuria / chemically induced*
  • Antineoplastic Agents / adverse effects*
  • Arteriosclerosis / chemically induced*
  • Blood Coagulation Factors / analysis
  • C-Reactive Protein / analysis
  • Cisplatin / adverse effects*
  • Cross-Sectional Studies
  • Fibrinolysis / drug effects*
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Orchiectomy
  • Testicular Neoplasms / blood
  • Testicular Neoplasms / drug therapy*
  • Testicular Neoplasms / surgery


  • Antineoplastic Agents
  • Blood Coagulation Factors
  • C-Reactive Protein
  • Cisplatin