Long-term changes in testosterone levels in testicular cancer survivors

Background

Few studies have used serial measurements of total testosterone (TT) to evaluate long-term changes after testicular cancer treatment. We aimed to evaluate changes in TT after completion of a five or ten year follow-up programme.

Methods

From a long-term follow-up study of testicular cancer survivors (NCT02240966), 78 patients were included. Inclusion criteria were: Available post-treatment measurements of TT and luteinizing hormone (LH) within the follow-up programme (visit 1) and measurement of TT and LH after completion of follow-up (visit 2). Androgen substitution and age > 65 years at visit 2 were exclusion criteria. Patients were divided according to treatment: unilateral orchiectomy + radiotherapy (14-20 Gy) due to contralateral germ cell neoplasia in situ (GCNIS) (n = 18), standard dose bleomycin, etoposide and cisplatin (BEP) (n = 19), retroperitoneal radiotherapy (n = 16) (RT), unilateral orchiectomy alone (Stage I) (n = 25). LH, TT and sexual hormone-binding globuline (SHBG) at visit 1 and visit 2 were compared within each treatment group with paired t-test.

Results

Time from treatment, age and reproductive hormones at visit 1 and visit 2 are presented in the table (median, interquartile range). TT declined in all treatment groups. In the GCNIS-group, 9/18 patients had TT levels 

Conclusions

Total testosterone declines after the completion of follow-up, irrespectively of treatment. TT is lowest in patients treated with radiotherapy due to contralateral GCNIS. Evaluation of testosterone levels should be continued beyond ten years in patients with GCNIS.

Clinical trial identification

NCT02240966

Legal entity responsible for the study

The Local Ethical Committee of the Capital Region of Denmark

Funding

Copenhagen University Hospital Rigshospitalet

Disclosure

All authors have declared no conflicts of interest.