title: Gonadal status in long-term male survivors of childhood cancer.
abstract: OBJECTIVE
  To evaluate the prevalence of gonadal dysfunction and the associated risk factors in a cohort of male childhood cancer survivors (CCS).
  
  
  METHODS
  Gonadal function was evaluated measuring FSH, LH, inhibin B and total testosterone levels. Patients with total testosterone <3 ng/dl were considered to have hypogonadism. Patients with FSH >10 UI/l and inhibin B <100 pg/ml were considered to have spermatogenesis damage (SD). To assess the impact of risk factors, we estimated crude and adjusted OR performing logistic regression models.
  
  
  RESULTS
  One hundred and ninety-nine male CCS were enrolled; the median follow-up time was 14.01 years. SD was diagnosed in 68 patients, 16 CCS had primary hypogonadism, and 13 had central hypogonadism. The prevalence of gonadal dysfunction (SD or primary hypogonadism) was 45 %, similar in the three considered periods of pediatric cancer diagnosis (1985-1989, 1990-1999, >2000). The adjusted risk of gonadal dysfunction was higher in patients treated with radiotherapy (OR = 8.72; 95 % CI 3.94-19.30) and in those exposed to both alkylating and platinum-derived agents (OR = 9.22; 95 % CI 2.17-39.23). Sarcomas were the cancer diagnosis associated with the higher risk of gonadal dysfunction (OR = 3.69; 95 % CI 1.11-12.22). An extremely high rate of gonadal dysfunction was detected in patients who underwent hematopoietic stem cell transplantation and/or total body irradiation.
  
  
  CONCLUSIONS
  Gonadal dysfunction still remains a significant late effect of anticancer therapies; thus, it is mandatory to inform patients (and parents) about this risk, and semen cryopreservation should be offered to all boys who are able to produce semen.
authors: Transition Unit for Childhood Cancer Survivors, Città della Salute e della Scienza Hospital , Via Cherasco, 15, 10126, Turin, Italy. ebrignardello@cittadellasalute.to.it.
authors: E
authors: E
authors: Brignardello
authors: Transition Unit for Childhood Cancer Survivors, Città della Salute e della Scienza Hospital , Via Cherasco, 15, 10126, Turin, Italy.
authors: F
authors: F
authors: Felicetti
authors: Unit of Clinical Epidemiology, Città della Salute e della Scienza Hospital, University of Turin and Centre for Cancer Epidemiology and Prevention (CPO Piemonte), Turin, Italy.
authors: A
authors: A
authors: Castiglione
authors: Transition Unit for Childhood Cancer Survivors, Città della Salute e della Scienza Hospital , Via Cherasco, 15, 10126, Turin, Italy.
authors: A
authors: A
authors: Nervo
authors: Pediatric Onco-Hematology, Città della Salute e della Scienza Hospital, Turin, Italy.
authors: E
authors: E
authors: Biasin
authors: Unit of Clinical Epidemiology, Città della Salute e della Scienza Hospital, University of Turin and Centre for Cancer Epidemiology and Prevention (CPO Piemonte), Turin, Italy.
authors: G
authors: G
authors: Ciccone
authors: Pediatric Onco-Hematology, Città della Salute e della Scienza Hospital, Turin, Italy.
authors: F
authors: F
authors: Fagioli
authors: Pediatric Endocrinology Unit, Città della Salute e della Scienza Hospital, Turin, Italy.
authors: A
authors: A
authors: Corrias
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy / Q000009:adverse effects*; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007006:Hypogonadism / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009367:Neoplasm Staging; D009369:Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate; D017741:Survivors
keywords: Childhood cancer survivors; Gonadal function; Late effects; Male infertility