High risk of hypogonadism in young male cancer survivors
| Autor: | Ingrid Øra, Olof Ståhl, I. Leijonhufvud, Patrik Romerius, Katarina Link, Karolina Bogefors, Jakob Eberhard, Johannes Bobjer, Yvonne Lundberg Giwercman, Sigrid Isaksson, Aleksander Giwercman |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.drug_class Endocrinology Diabetes and Metabolism medicine.medical_treatment 030209 endocrinology & metabolism Gastroenterology 03 medical and health sciences Young Adult 0302 clinical medicine Endocrinology Life Expectancy Cancer Survivors Testicular Neoplasms Risk Factors Internal medicine medicine Humans Testosterone Young adult Child Testicular cancer Chemotherapy 030219 obstetrics & reproductive medicine business.industry Hypogonadism fungi Cancer Odds ratio medicine.disease Androgen Case-Control Studies Cisplatin Luteinizing hormone business |
| Zdroj: | Clinical endocrinology. 88(3) |
| ISSN: | 1365-2265 |
| Popis: | Objective: Cancer and its treatment in childhood and young adulthood can cause hypogonadism, leading to increased risk of long-term morbidity and mortality. The aim of this study was to evaluate the risk of presenting with biochemical signs of hypogonadism in testicular cancer survivors (TCS) and male childhood cancer survivors (CCS) in relation to the type of treatment given. Design: Case-control study. Patients: Ninety-two TCS, 125 CCS (mean age 40 and median age 34 years, respectively; mean follow-up time 9.2 and 24 years, respectively) and a corresponding number of age-matched controls. Measurements: Fasting morning blood samples were analysed for total testosterone (TT), follicle-stimulating hormone (FSH) and luteinizing hormone (LH). The odds ratios (OR) for hypogonadism, defined as primary, secondary, compensated or ongoing androgen replacement, were calculated for TCS and CCS and for subgroups defined by diagnosis and treatment. Results: Hypogonadism was found in 26% of CCS and 36% of TCS, respectively (OR: 2.1, P = .025 and OR = 2.3, P = .021). Among CCS, the OR was further increased in those given testicular irradiation (OR = 28, P = .004). Radiotherapy other than cranial or testicular irradiation plus chemotherapy, or cranial irradiation without chemotherapy, associated also with increased ORs (OR = 3.7, P = .013, and OR = 4.4, P = .038, respectively). Among TCS, those receiving >4 cycles of cisplatin-based chemotherapy had OR = 17, P = .015. Conclusions: Biochemical signs of testosterone deficiency are recognized as markers of decreased life expectancy. Thus, the risk of hypogonadism in TCS and CCS should be recognized and emphasizes the need of long-term follow-up for these men. |
| Databáze: | OpenAIRE |
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