Abstract
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. CLINICALTRIALS: gov Identifier: NCT03880994.