Longitudinal serum testosterone, luteinizing hormone, and follicle-stimulating hormone levels in a population-based sample of long-term testicular cancer survivors - Abstract

PURPOSE: To assess longitudinal long-term alterations of testosterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) in testicular cancer survivors (TCSs).

PATIENTS AND 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 χ2 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.

CONCLUSION: 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.

Written by:
Sprauten M, Brydøy M, Haugnes HS, Cvancarova M, Bjøro T, Bjerner J, Fosså SD, Oldenburg J   Are you the author?
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

Reference: J Clin Oncol. 2014 Jan 13. (Epub ahead of print)
doi: 10.1200/JCO.2013.51.2715

PubMed Abstract
PMID: 24419125

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