Hepatic steatosis development as a long-term complication among testicular germ cell tumor survivors

Hepatic steatosis (HS) development and its risk factors in testicular germ cell tumor (TGCT) survivors have not been investigated.

The study was designed as a retrospective observational study. Patients with existing HS at diagnosis were excluded. Serial imaging was utilized to detect HS.

A total of 106 TGCT survivors were included. HS developed in 57% (n = 61) during a median follow-up of 51.8 months (8.5-241.5); 77% (n = 47) of those had persistent HS. Patients who developed HS had a higher baseline body mass index (BMI) (median 26.5 vs. 23.6 kg/m², p = 0.000). Higher baseline BMI [adjusted odds ratio (aOR): 1.35, (95% CI: 1.10-1.65) p = 0.004] and S0 stage [aOR: 3.87, (95% CI: 1.18-12.67), p = 0.025] were associated with a higher risk of HS development. The median time from the diagnosis of TGCT to the detection of HS was 44.7 months (29.5-59.8). Higher baseline BMI was associated with earlier development of HS both in all patients [hazard ratio (HR): 1.16, (95% CI: 1.04-1.30), p = 0.007] and patients treated with the BEP regimen [HR: 1.21, (95% CI: 1.01-1.47), p = 0.038].

HS may be considered a long-term complication in TGCT patients. The risk is associated with baseline BMI. Diagnosis and management of HS should be implemented in the survivorship care plan of TGCT survivors.