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Purpose <p>Research shows that testicular cancer patients (TCPs) evidence cognitive impairment (CI) in the absence of systemic therapy, suggesting that the cancer itself or surgery may play a role. In the present study, we undertook longitudinal cognitive assessments in TCPs from pre- to post-orchiectomy.</p> Methods <p>Enrolled TCPs underwent cognitive assessment with the Cambridge Neuropsychological Test Automated Battery prior to orchiectomy (T1) and 9&#xa0;months later (T2). Test outcomes were norm-adjusted and converted to <i>z</i> scores. A mean global composite score (GCS) across all tests was calculated. A standardized regression-based approach was used for the longitudinal analyses. Biological markers, including lactate dehydrogenase (LDH) and alpha-fetoprotein (AFP), were also assessed.</p> Results <p>Of 48 eligible patients, 29 (60%) participated and 20 (69%) underwent follow-up assessment. Mean <i>z</i> scores (SD) at pre-orchiectomy ranged from − 0.16 (0.73) to 0.53 (0.76). GCS was 0.26 (0.64) with three TCPs (10.3%) evidencing clinically significant CI. Mean standardized change <i>z</i> scores from pre- to post-orchiectomy ranged from − 0.42 (0.87) to 0.67 (0.76). A statistically significant decrease in GCS was observed from T1 to T2 (<i>p</i> = .03). Statistically significant associations were observed between LDH and several cognitive domains (<i>r</i>’s = − .48 to − .52), and between AFP and executive function (<i>r</i> = − .44).</p> Conclusion <p>Overall, the prevalence of CI was low, and cognitive performance from pre- to post-orchiectomy was within a normative range. However, a decrease in overall cognitive function was noted, and a possible association was observed&#xa0;between cognitive performance and LDH and AFP. </p> <p>Trial registration.</p> <p>ClinicalTrials.gov Identifier: NCT03880994.</p>

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Longitudinal assessment of cognitive function in testicular cancer patients prior to orchiectomy and 9 months later and associations with tumor markers

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月17日

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  • Niels Fog Højris,
  • Yoon Frederiksen,
  • Mads Agerbæk,
  • Solvej Heeringa Nielsen,
  • Mick Holt,
  • Signe Lehn Brand,
  • Nikoline Lysemose Petersen,
  • Ulla Breth Knudsen,
  • Ali Amidi

摘要

Purpose

Research shows that testicular cancer patients (TCPs) evidence cognitive impairment (CI) in the absence of systemic therapy, suggesting that the cancer itself or surgery may play a role. In the present study, we undertook longitudinal cognitive assessments in TCPs from pre- to post-orchiectomy.

Methods

Enrolled TCPs underwent cognitive assessment with the Cambridge Neuropsychological Test Automated Battery prior to orchiectomy (T1) and 9 months later (T2). Test outcomes were norm-adjusted and converted to z scores. A mean global composite score (GCS) across all tests was calculated. A standardized regression-based approach was used for the longitudinal analyses. Biological markers, including lactate dehydrogenase (LDH) and alpha-fetoprotein (AFP), were also assessed.

Results

Of 48 eligible patients, 29 (60%) participated and 20 (69%) underwent follow-up assessment. Mean z scores (SD) at pre-orchiectomy ranged from − 0.16 (0.73) to 0.53 (0.76). GCS was 0.26 (0.64) with three TCPs (10.3%) evidencing clinically significant CI. Mean standardized change z scores from pre- to post-orchiectomy ranged from − 0.42 (0.87) to 0.67 (0.76). A statistically significant decrease in GCS was observed from T1 to T2 (p = .03). Statistically significant associations were observed between LDH and several cognitive domains (r’s = − .48 to − .52), and between AFP and executive function (r = − .44).

Conclusion

Overall, the prevalence of CI was low, and cognitive performance from pre- to post-orchiectomy was within a normative range. However, a decrease in overall cognitive function was noted, and a possible association was observed between cognitive performance and LDH and AFP.

Trial registration.

ClinicalTrials.gov Identifier: NCT03880994.