title: The pituitary-Leydig cell axis before and after orchiectomy in patients with stage I testicular cancer.
abstract: BACKGROUND
  This study investigates the pituitary-Leydig cell axis in patients with stage I testicular germ cell cancer (TGCC) followed with surveillance only, in order to evaluate the risk of Leydig cell dysfunction one year after orchiectomy.
  
  
  METHODS
  A retrospective evaluation of reproductive hormones in patients with unilateral stage I TGCC (N=72) without relapse diagnosed between 1990 and 2008. A group of healthy males (N=706) served as controls.
  
  
  RESULTS
  Before orchiectomy there were no significant differences in luteinizing hormone (LH) and testosterone (T) levels between human chorionic gonadotropin (hCG)-negative patients and controls, although 33% of the patients were outside the 97.5 percentile when using bivariate LH/T evaluation. At 1-year follow-up there was a significant increase in LH (ΔLH=2.04IU/L, p<0.001), and 57% of the patients had an LH/T relation outside the 97.5 percentile.
  
  
  CONCLUSIONS
  Patients with stage I TGCC are at increased risk of having an LH/T relation outside the normal range one year after orchiectomy, suggesting insufficient Leydig-cell function. Whether a proportion of these patients will develop manifest hypogonadism and benefit from androgen therapy is yet to be clarified.
authors.affiliation: Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, Copenhagen, Denmark. mibandak@gmail.com
authors.forename: Mikkel
authors.initials: M
authors.lastname: Bandak
authors.forename: Lise
authors.initials: L
authors.lastname: Aksglaede
authors.forename: Anders
authors.initials: A
authors.lastname: Juul
authors.forename: Mikael
authors.initials: M
authors.lastname: Rørth
authors.forename: Gedske
authors.initials: G
authors.lastname: Daugaard
mesh_terms: D000328:Adult; D006063:Chorionic Gonadotropin / Q000097:blood; D015331:Cohort Studies; D004958:Estradiol / Q000097:blood; D006801:Humans; D007985:Leydig Cells / Q000502:physiology*; D007986:Luteinizing Hormone / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009919:Orchiectomy; D010902:Pituitary Gland / Q000503:physiopathology; D012189:Retrospective Studies; D013736:Testicular Neoplasms / Q000097:blood* / Q000473:pathology / Q000601:surgery; D013739:Testosterone / Q000097:blood*; D055815:Young Adult
chemical_list: D006063:Chorionic Gonadotropin; D013739:Testosterone; D004958:Estradiol; D007986:Luteinizing Hormone