Gonadal hormones in long-term survivors 10 years after treatment for unilateral testicular cancer.
OBJECTIVE
To investigate whether unilaterally orchiectomised testicular cancer survivors (TCSs) are more likely to display reduced Leydig cell function than healthy males.


METHODS
A national multi-centre survey of 1235 TCSs was performed in 1998-2000 (mean age: 44 years) treated between 1980 and 1994 (mean follow-up: 11 years). Serum hormone analyses were performed on 1183 TCSs, as 52 TCSs used androgen replacement (AR). TCSs were allocated to four treatment groups: Surgery only (251); Radiotherapy only (515); Chemotherapy 1, cisplatin </=850 mg (373); Chemotherapy 2, cisplatin >850 mg (96). The Controls were represented by 200 healthy blue-collar workers (mean age: 44 years). LH >12 IU/l and testosterone <8 nmol/l and the use of AR indicated hypogonadism.


RESULTS
Serum testosterone was similar in TCSs and Controls (16.9 vs.17.1 nmol/l), but TCSs had higher age-adjusted LH levels than the Controls (5.2 vs. 3.5 IU/l). LH increased with treatment intensity, but was elevated even in TCSs treated with surgery only. The age-adjusted odds ratio of hypogonadism was 3.8 (95%CI: 2.0-7.3) in TCSs, and increased with treatment intensity.


CONCLUSIONS
TCSs are at risk to develop pre-mature reduced Leydig cell function and hypogonadism. They may therefore be predisposed for the syndrome of androgen deficiency of aging males (ADAM).
Nord
Carina
C
Department of Clinical Research, The Norwegian Radiumhospital, University Hospital, Montebello, 0310, Oslo, Norway. carina.nord@klinmed.uio.no
Bjøro
Trine
T
Ellingsen
Dag
D
Mykletun
Arnstein
A
Dahl
Olav
O
Klepp
Olbjørn
O
Bremnes
Roy M
RM
Wist
Erik
E
Fosså
Sophie D
SD
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D016022:Case-Control Studies; D015897:Comorbidity; D042341:Gonadal Hormones / Q000097:blood*; D006801:Humans; D007006:Hypogonadism / Q000453:epidemiology; D016015:Logistic Models; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D011159:Population Surveillance; D012016:Reference Values; D017741:Survivors / Q000706:statistics & numerical data*; D013736:Testicular Neoplasms / Q000097:blood* / Q000453:epidemiology* / Q000628:therapy; D013739:Testosterone / Q000097:blood
D042341:Gonadal Hormones; D013739:Testosterone; D007986:Luteinizing Hormone