S Isaksson1,2, K Bogefors1,2, O Ståhl2, J Eberhard2, Y L Giwercman1, I Leijonhufvud1,3, K Link1, I Øra4, P Romerius4, J Bobjer1,5, A Giwercman1,3. 1. Molecular Reproductive Medicine Unit, Department of Translational Medicine, Lund University, Malmö, Sweden. 2. Department of Oncology, Skane University Hospital, Malmö and Lund, Sweden. 3. Reproductive Medicine Centre, Skane University Hospital, Malmö, Sweden. 4. Department of Pediatrics, Pediatric Oncology, Clinical Sciences, Lund University, Lund, Sweden. 5. Department of Urology, Skane University Hospital, Malmö, Sweden.
Abstract
OBJECTIVE: Cancer and its treatment in childhood and young adulthood can cause hypogonadism, leading to increased risk of long-term morbidity and mortality. The aim of this study was to evaluate the risk of presenting with biochemical signs of hypogonadism in testicular cancer survivors (TCS) and male childhood cancer survivors (CCS) in relation to the type of treatment given. DESIGN: Case-control study. PATIENTS: Ninety-two TCS, 125 CCS (mean age 40 and median age 34 years, respectively; mean follow-up time 9.2 and 24 years, respectively) and a corresponding number of age-matched controls. MEASUREMENTS: Fasting morning blood samples were analysed for total testosterone (TT), follicle-stimulating hormone (FSH) and luteinizing hormone (LH). The odds ratios (OR) for hypogonadism, defined as primary, secondary, compensated or ongoing androgen replacement, were calculated for TCS and CCS and for subgroups defined by diagnosis and treatment. RESULTS: Hypogonadism was found in 26% of CCS and 36% of TCS, respectively (OR: 2.1, P = .025 and OR = 2.3, P = .021). Among CCS, the OR was further increased in those given testicular irradiation (OR = 28, P = .004). Radiotherapy other than cranial or testicular irradiation plus chemotherapy, or cranial irradiation without chemotherapy, associated also with increased ORs (OR = 3.7, P = .013, and OR = 4.4, P = .038, respectively). Among TCS, those receiving >4 cycles of cisplatin-based chemotherapy had OR = 17, P = .015. CONCLUSIONS: Biochemical signs of testosterone deficiency are recognized as markers of decreased life expectancy. Thus, the risk of hypogonadism in TCS and CCS should be recognized and emphasizes the need of long-term follow-up for these men.
OBJECTIVE:Cancer and its treatment in childhood and young adulthood can cause hypogonadism, leading to increased risk of long-term morbidity and mortality. The aim of this study was to evaluate the risk of presenting with biochemical signs of hypogonadism in testicular cancer survivors (TCS) and male childhood cancer survivors (CCS) in relation to the type of treatment given. DESIGN: Case-control study. PATIENTS: Ninety-two TCS, 125 CCS (mean age 40 and median age 34 years, respectively; mean follow-up time 9.2 and 24 years, respectively) and a corresponding number of age-matched controls. MEASUREMENTS: Fasting morning blood samples were analysed for total testosterone (TT), follicle-stimulating hormone (FSH) and luteinizing hormone (LH). The odds ratios (OR) for hypogonadism, defined as primary, secondary, compensated or ongoing androgen replacement, were calculated for TCS and CCS and for subgroups defined by diagnosis and treatment. RESULTS:Hypogonadism was found in 26% of CCS and 36% of TCS, respectively (OR: 2.1, P = .025 and OR = 2.3, P = .021). Among CCS, the OR was further increased in those given testicular irradiation (OR = 28, P = .004). Radiotherapy other than cranial or testicular irradiation plus chemotherapy, or cranial irradiation without chemotherapy, associated also with increased ORs (OR = 3.7, P = .013, and OR = 4.4, P = .038, respectively). Among TCS, those receiving >4 cycles of cisplatin-based chemotherapy had OR = 17, P = .015. CONCLUSIONS: Biochemical signs of testosterone deficiency are recognized as markers of decreased life expectancy. Thus, the risk of hypogonadism in TCS and CCS should be recognized and emphasizes the need of long-term follow-up for these men.
Authors: Wassim Chemaitilly; Qi Liu; Laura van Iersel; Kirsten K Ness; Zhenghong Li; Carmen L Wilson; Tara M Brinkman; James L Klosky; Nicole Barnes; Karen L Clark; Rebecca M Howell; Susan A Smith; Matthew J Krasin; Monika L Metzger; Gregory T Armstrong; Michael W Bishop; Hanneke M van Santen; Ching-Hon Pui; Deo Kumar Srivastava; Yutaka Yasui; Melissa M Hudson; Leslie L Robison; Daniel M Green; Charles A Sklar Journal: J Clin Oncol Date: 2019-09-26 Impact factor: 44.544
Authors: Kyle K VanKoevering; Katayoon Sabetsarvestani; Stephen E Sullivan; Ariel Barkan; Michelle Mierzwa; Erin L McKean Journal: J Neurol Surg B Skull Base Date: 2019-02-21
Authors: Mohammad Abu Zaid; Paul C Dinh; Patrick O Monahan; Chunkit Fung; Omar El-Charif; Darren R Feldman; Robert J Hamilton; David J Vaughn; Clair J Beard; Ryan Cook; Sandra Althouse; Shirin Ardeshir-Rouhani-Fard; Howard D Sesso; Robert Huddart; Taisei Mushiroda; Michiaki Kubo; M Eileen Dolan; Lawrence H Einhorn; Sophie D Fossa; Lois B Travis Journal: J Natl Compr Canc Netw Date: 2019-05-01 Impact factor: 11.908