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Longitudinal Changes in Serum Levels of Testosterone and Luteinizing Hormone in Testicular Cancer Patients after Orchiectomy Alone or Bleomycin, Etoposide, and Cisplatin

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  1. Male Sexual and Reproductive Health-Does the Urologist Have a Role in Addressing Gender Inequality in Life Expectancy?

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  2. Sexual Function and Quality of Life in a National Cohort of Survivors of Bilateral Testicular Cancer

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  3. The CPC Risk Calculator: A New App to Predict Prostate-specific Antigen Recurrence During Follow-up After Radical Prostatectomy

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  1. Growth and Adult Height in Girls With Turner Syndrome Following IGF-1 Titrated Growth Hormone Treatment

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  2. Sexual Function and Quality of Life in a National Cohort of Survivors of Bilateral Testicular Cancer

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Male Sexual Function after Allogeneic Hematopoietic Stem Cell Transplantation in Childhood: A Multicenter Study

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  4. Distinguishing between hidden testes and anorchia: The role of endocrine evaluation in infancy and childhood

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  5. Heritability of pubertal timing: detailed evaluation of specific milestones in healthy boys and girls

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BACKGROUND: Controversy exists whether Leydig cells recover after testicular cancer (TC) treatment or whether premature hormonal aging will occur.

OBJECTIVE: Evaluate serial changes in total testosterone (TT) and luteinizing hormone (LH) in patients treated with orchiectomy alone (Stage I) or combination chemotherapy with bleomycin, etoposide, and cisplatin (BEP).

DESIGN, SETTINGS, AND PARTICIPANTS: Changes in TT and LH were investigated during 5-yr follow-up (Stage I: n=75, BEP: n=81). A selected group of TC patients with mild Leydig cell dysfunction (LH ≥ 8 IU/l) were followed for a longer period (Stage I: n=20, BEP: n=23). An age-matched control group of 839 healthy men served as controls for TT and LH levels.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Changes in age-adjusted TT and LH were evaluated separately in each treatment group with univariate linear regression analysis. The proportion of patients initiating testosterone substitution during follow-up was calculated.

RESULTS AND LIMITATIONS: In the 75 Stage I patients there were no significant changes in LH and TT, while in the 81 BEP treated patients there was a significant decline in LH during follow-up (-24.2 percentage point/yr, 95% confidence interval: -38.5 to -9.9, p=0.001). In total, 11% of Stage I patients and 15% of BEP-treated patients initiated testosterone substitution. In the 23 BEP-treated patients with mild Leydig cell dysfunction there was a significant decline in age-adjusted TT (-0.9 percentage point/yr, 95% confidence interval: -1.8 to -0.04, p=0.04), while in the 20 Stage I patients there were no significant changes in age-adjusted LH and TT. Limitations include the retrospective study design.

CONCLUSIONS: TT remained stable during 5-yr follow-up in TC patients treated with orchiectomy alone or BEP. BEP-treated patients with mild Leydig cell dysfunction during follow-up were at risk of long-term testicular failure and evaluation of Leydig cell function beyond follow-up should be considered in this group of patients.

PATIENT SUMMARY: This study shows that the majority of testicular cancer survivors had stable testosterone levels after treatment for testicular cancer. However, 11-15% of patients needed testosterone substitution after treatment.

Original languageEnglish
JournalEuropean Urology Focus
Volume4
Issue number4
Pages (from-to)591-598
ISSN2405-4569
DOIs
Publication statusPublished - 2018

    Research areas

  • Journal Article

ID: 52171123