Platinum-based Chemotherapy and Its Cardiovascular Impact on Long-term Survival in Male Patients with Germ Cell Tumours

Germ cell tumours (GCTs) are the most common malignancies in young male patients, with platinum-based chemotherapy regimens significantly improving survival over recent decades. However, this therapeutic success has brought a growing concern regarding long-term cardiovascular (CV) complications, which now represent a major contributor to morbidity and mortality in this population. In this retrospective study, we reviewed male patients with GCTs treated between 2005 and 2022 at a tertiary centre, focusing on the relationship between platinum-based chemotherapy and the incidence of CV events, as well as overall survival. Clinical data included cardiovascular risk profiles, oncological treatments, and major CV outcomes such as myocardial infarction, venous thromboembolism, arrhythmias, and heart failure. A notable proportion of patients experienced at least one CV event, often occurring several years after chemotherapy completion. Venous thromboembolism and coronary events were particularly frequent, and patients with existing risk factors such as smoking, hypertension, and dyslipidaemia were more susceptible. Importantly, the occurrence of CV events was associated with a significant reduction in long-term survival. These findings emphasise the need to integrate cardiovascular risk assessment and monitoring into the routine follow-up of patients treated with platinum-based chemotherapy. Early identification of at- risk individuals and the development of cardio-oncology care pathways are essential to improving long-term outcomes. Our study reinforces the importance of balancing oncological efficacy with the prevention of delayed toxicity and supports a multidisciplinary approach to the survivorship care of testicular cancer patients.