Long-term follow-up of testicular cancer patients shows no predisposition to osteoporosis.
Most patients with testis cancer are cured with treatment. However, the incidence of osteoporosis after prolonged follow-up is unknown. This study investigates the incidence of osteoporosis in 39 testis cancer patients with follow-up from 5 to 28 years. There was no increased incidence of osteoporosis. These initial data are reassuring but require further investigation.


BACKGROUND
The majority of patients with testis cancer are cured with either a unilateral orchidectomy alone or orchidectomy and chemotherapy. However, the long-term incidence of osteoporosis following treatment for testicular cancer has not been established.


METHODS
This was a single-centre cross-sectional study, where bone mineral density (BMD) measurements were performed in male patients who were previously treated for testicular cancer. BMD measurements were made by dual-energy X-ray scanning (DXA) using a HOLOGIC imaging bone densitometer. The World Health Organisation criteria were used to define osteoporosis and osteopenia. Blood samples were taken from each patient at the time of the DXA scan. Statistical analyses were performed in STATA10.


RESULTS
Neither orchidectomy alone nor orchidectomy and chemotherapy together predisposed to osteoporosis [p value = 0.4 (95%CI -0.1-0.8) and p value = 0.2 (95%CI -0.2-0.7), respectively]. Analysis also showed no evidence of an association between cases of osteopenia and length of follow-up (assessed by logistic regression).


CONCLUSIONS
This work found no association between treatment for testis cancer and the development of osteoporosis. Screening the whole population of testis cancer survivors for osteoporosis in the long term is not necessary; however, targeting specific patients with risk factors may be warranted.
Murugaesu
N
N
Department of Medical Oncology, St Bartholomew's Hospital, Gloucester House, West Smithfield, London, EC1A 7BE, UK.
Powles
T
T
Bestwick
J
J
Oliver
R T D
RT
Shamash
J
J
D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects; D015519:Bone Density; D002945:Cisplatin / Q000009:adverse effects; D003430:Cross-Sectional Studies; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009919:Orchiectomy / Q000009:adverse effects; D010024:Osteoporosis / Q000209:etiology*; D012307:Risk Factors; D013736:Testicular Neoplasms / Q000628:therapy*
D000970:Antineoplastic Agents; D002945:Cisplatin