title: Risk factors for post-treatment hypogonadism in testicular cancer patients.
abstract: OBJECTIVE
  Testicular germ-cell cancer (TGCC) patients are at risk of developing hypogonadism but no risk factors have yet been defined.
  
  
  METHODS
  Blood was collected from 143 TGCC patients (after orchidectomy, prior to further therapy (T0) and 6, 12, 24, 36 and 60 months (T6, T12, T24, T36 and T60) after therapy). Biological hypogonadism (BH) was defined as: serum testosterone below 10 nmol/l and/or LH >10 IU/l; odds ratios (ORs) for BH with BH at T0, age, stage of disease, testicular characteristics, and androgen receptor polymorphism as predictors were calculated as well as the OR for developing BH post-treatment (one to two cycles of adjuvant chemotherapy (ACT) versus three to four cycles of higher dose chemotherapy (HCT) versus adjuvant radiotherapy (RT)).
  
  
  RESULTS
  HCT increased the OR for BH at T6 (OR 22, 95% confidence interval (CI) 4.4-118) and T12 (OR 5.8, 95% CI 1.5-22). RT increased the OR at T6 (OR 10, 95% CI 2.1-47) and at T12 (OR 3.9, 95% CI 1.1-14). Microlithiasis predicted BH at T0 (OR 11, 95% CI 1.2-112), T12 (OR 3.9, 95% CI 1.1-13), T24 (OR 3.0, 95% CI 1.0-8.8), T36 (OR 5.4, 95% CI 1.7-17) and T60 (OR 4.4, 95% CI 1.2-16). BH at T0 was a risk for BH at T6 (OR 53, 95% CI 19-145), T12 (OR 125, 95% CI 37-430), T24 (OR 88, 95% CI 26-300) and T36 (OR 121, 95% CI 32-460).
  
  
  CONCLUSIONS
  It is clinically relevant that BH at T0 and testicular microlithiasis were predictive factors for post-treatment BH. HCT and RT gave temporary BH.
authors: Department of Oncology, Lund University Hospital, Lund University, SE 22185 Lund, Sweden. jakob.eberhard@med.lu.se
authors: Jakob
authors: J
authors: Eberhard
authors: Olof
authors: O
authors: Ståhl
authors: Magdalena
authors: M
authors: Cwikiel
authors: Eva
authors: E
authors: Cavallin-Ståhl
authors: Yvonne
authors: Y
authors: Giwercman
authors: Eva Cecilia
authors: EC
authors: Salmonson
authors: Aleksander
authors: A
authors: Giwercman
mesh_terms: D000328:Adult; D000465:Algorithms; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D003131:Combined Modality Therapy / Q000009:adverse effects; D003561:Cytarabine / Q000009:adverse effects / Q000627:therapeutic use; D004317:Doxorubicin / Q000009:adverse effects / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D007006:Hypogonadism / Q000097:blood / Q000209:etiology*; D020347:Lithiasis / Q000150:complications; D008137:Longitudinal Studies; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000097:blood / Q000601:surgery*; D009919:Orchiectomy / Q000009:adverse effects; D011446:Prospective Studies; D011832:Radiation Injuries / Q000150:complications; D011878:Radiotherapy / Q000009:adverse effects; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D012307:Risk Factors; D013733:Testicular Diseases / Q000150:complications; D013736:Testicular Neoplasms / Q000097:blood / Q000628:therapy*; D013739:Testosterone / Q000097:blood; D013866:Thioguanine / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D003561:Cytarabine; D013739:Testosterone; D004317:Doxorubicin; D013866:Thioguanine