title: Longitudinal serum testosterone, luteinizing hormone, and follicle-stimulating hormone levels in a population-based sample of long-term testicular cancer survivors.
abstract: OBJECTIVE
  To assess longitudinal long-term alterations of testosterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) in testicular cancer survivors (TCSs).
  
  
  METHODS
  In all, 307 TCSs treated from 1980 to 1994 provided blood samples after orchiectomy but before further treatment, at Survey I (SI; 1998-2002), and Survey II (SII; 2007-2008). Levels of sex hormones were categorized according to quartiles and reference range (2.5 and 97.5 percentiles) of 599 controls for each decadal age group. TCSs were categorized according to treatment: surgery, radiotherapy (RT), or chemotherapy (CT). The risk of higher (LH) or lower (testosterone) levels was assessed with χ(2) test (FSH) or ordinal logistic regression analysis and expressed as odds ratios (ORs) with 95% CIs.
  
  
  RESULTS
  Risk of lower testosterone and higher LH and FSH levels was significantly increased for TCSs at all time points after RT or CT. At SII, ORs were 3.3 (95% CI, 2.3 to 4.7) for lower testosterone categories and 5.2 (95% CI, 3.5 to 7.9) for RT and CT. ORs for increased LH and FSH were 4.4 (95% CI, 3.1 to 6.5) and 18.9 (95% CI, 11.0 to 32.6) for RT, respectively, and 3.6 (95% CI, 2.4 to 5.3) and 14.2 (95% CI, 8.3 to 24.4) for CT, respectively. The cumulative platinum dose was significantly associated with risk of higher LH levels at both surveys and higher FSH at SI. In total, half the TCSs had at least one of three sex hormone levels outside the reference range at SII.
  
  
  CONCLUSIONS
  Long-term TCSs are at risk of premature hormonal aging. Our findings may pertain to cancer survivors in general, underlining the importance of extended follow-up.
authors.affiliation: Mette Sprauten, Milada Cvancarova, Sophie D. Fosså, and Jan Oldenburg, Oslo University Hospital; Trine Bjøro, Oslo University Hospital and University of Oslo; Johan Bjerner, Fürst Medical Laboratory, Oslo; Marianne Brydøy, University of Bergen, Bergen; and Hege S. Haugnes, University of Tromsø and University Hospital of North Norway, Tromsø, Norway.
authors.forename: Mette
authors.initials: M
authors.lastname: Sprauten
authors.forename: Marianne
authors.initials: M
authors.lastname: Brydøy
authors.forename: Hege S
authors.initials: HS
authors.lastname: Haugnes
authors.forename: Milada
authors.initials: M
authors.lastname: Cvancarova
authors.forename: Trine
authors.initials: T
authors.lastname: Bjøro
authors.forename: Johan
authors.initials: J
authors.lastname: Bjerner
authors.forename: Sophie D
authors.initials: SD
authors.lastname: Fosså
authors.forename: Jan
authors.initials: J
authors.lastname: Oldenburg
mesh_terms: D000293:Adolescent; D000328:Adult; D005640:Follicle Stimulating Hormone / Q000097:blood*; D006801:Humans; D008137:Longitudinal Studies; D007986:Luteinizing Hormone / Q000097:blood*; D008297:Male; D008875:Middle Aged; D017741:Survivors; D013736:Testicular Neoplasms / Q000097:blood*; D013739:Testosterone / Q000097:blood*; D055815:Young Adult
chemical_list: D013739:Testosterone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone