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The effects of hypogonadism on quality of life in survivors of germ cell tumors treated with surgery alone versus surgery plus platinum-based chemotherapy

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Abstract

Background

It is important to assess the prevalence of hypogonadism and to identify the correlation between hypogonadism and cancer treatment with quality of life (QoL) in germ cell tumor (GCT) survivors.

Methods

This is a single-center, non-randomized, prospective observational study in GCT survivors 18–50 years of age previously treated with surgery and chemotherapy (S+C) or surgery alone (S). Patients completed a validated QoL questionnaire at baseline, 3, and 6 months. Patients received supplemental testosterone as clinically indicated. Mean QoL scores were compared between two treatment groups (S+C vs. S) and within each group between survivors with hypogonadism (serum testosterone level < 300 ng/dL) versus without. A two-sided independent-groups t test was used to compare means.

Results

We evaluated 199 GCT survivors. At baseline, the prevalence of biochemical hypogonadism was 48% overall, 51% in S+C group, and 45% in S group (p = .4). Overall, there was no statistically significant difference in QoL scores between S+C and C groups, except the S+C group exhibited greater modified Aging Male Symptoms (AMS) at baseline and 6 months. Patients with hypogonadism reported more fatigue, poor sleep quality, and worse general health at baseline. There were no statistical differences in mean QOL scores between patients with testosterone < 300 ng/dL who received testosterone supplementation and who did not.

Conclusion

A significant proportion of GCT survivors have low testosterone levels after platinum-based chemotherapy and surgery as well as with just surgery alone. GCT survivors treated with platinum-based chemotherapy exhibited more symptoms related to male aging compared with survivors treated with surgery alone.

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References

  1. Siegel RL, Miller KD, Jemal A (2017) Cancer statistics, 2017. CA Cancer J Clin 67(1):7–30

    Article  Google Scholar 

  2. Kerns SL, Fung C, Monahan PO, Ardeshir-Rouhani-Fard S, Abu Zaid MI, Williams AM, Stump TE, Sesso HD, Feldman DR, Hamilton RJ, Vaughn DJ, Beard C, Huddart RA, Kim J, Kollmannsberger C, Sahasrabudhe DM, Cook R, Fossa SD, Einhorn LH, Travis LB, Platinum Study Group (2018) Cumulative burden of morbidity among testicular cancer survivors after standard cisplatin-based chemotherapy: a multi-institutional study. J Clin Oncol 36(15):1505–1512

    Article  CAS  Google Scholar 

  3. Mykletun A et al (2005) Side effects and cancer-related stress determine quality of life in long-term survivors of testicular Cancer. J Clin Oncol 23(13):3061–3068

    Article  Google Scholar 

  4. Nord C, Bjøro T, Ellingsen D, Mykletun A, Dahl O, Klepp O, Bremnes RM, Wist E, Fosså SD (2003) Gonadal hormones in long-term survivors 10 years after treatment for unilateral testicular cancer. Eur Urol 44(3):322–328

    Article  Google Scholar 

  5. Huddart RA, Norman A, Moynihan C, Horwich A, Parker C, Nicholls E, Dearnaley DP (2005) Fertility, gonadal and sexual function in survivors of testicular cancer. Br J Cancer 93(2):200–207

    Article  CAS  Google Scholar 

  6. Boer H, Proost JH, Nuver J, Bunskoek S, Gietema JQ, Geubels BM, Altena R, Zwart N, Oosting SF, Vonk JM, Lefrandt JD, Uges DR, Meijer C, de Vries EG, Gietema JA (2015) Long-term exposure to circulating platinum is associated with late effects of treatment in testicular cancer survivors. Ann Oncol 26(11):2305–2310

    Article  CAS  Google Scholar 

  7. Petak SM, Nankin HR, Spark RF, Swerdloff RS, Rodriguez-Rigau LJ, American Association of Clinical Endocrinologists (2002) American Association of Clinical Endocrinologists Medical Guidelines for clinical practice for the evaluation and treatment of hypogonadism in adult male patients--2002 update. Endocr Pract 8(6):440–456

    PubMed  Google Scholar 

  8. Giannetta E et al (2012) Subclinical male hypogonadism. Best Pract Res Clin Endocrinol Metab 26(4):539–550

    Article  CAS  Google Scholar 

  9. Ware JEJ (2000) SF-36 health survey update. Spine 25(24):3130–3139

    Article  Google Scholar 

  10. Heinemann LAJ et al (2003) The Aging Males’ Symptoms (AMS) scale: update and compilation of international versions. Health Qual Life Outcomes 1:15–15

    Article  Google Scholar 

  11. Daig I et al (2003) The Aging Males’ Symptoms (AMS) scale: review of its methodological characteristics. Health Qual Life Outcomes 1(1):77

    Article  Google Scholar 

  12. Liu H, Cella D, Gershon R, Shen J, Morales LS, Riley W, Hays RD (2010) Representativeness of the patient-reported outcomes measurement information system internet panel. J Clin Epidemiol 63(11):1169–1178

    Article  Google Scholar 

  13. Bhasin S, Cunningham GR, Hayes FJ, Matsumoto AM, Snyder PJ, Swerdloff RS, Montori VM, Task Force, Endocrine Society (2010) Testosterone therapy in men with androgen deficiency syndromes: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 95(6):2536–2559

    Article  CAS  Google Scholar 

  14. Anawalt BD (2010) Guidelines for testosterone therapy for men: how to avoid a mad (t)ea party by getting personal. J Clin Endocrinol Metab 95(6):2614–2617

    Article  CAS  Google Scholar 

  15. Zaid MIA et al (2017) Metabolic syndrome (MetS) after platinum-based chemotherapy (CHEM): a multicenter study of North American testicular cancer survivors (TCS). J Clin Oncol 35(5_suppl):102–102

    Article  Google Scholar 

  16. Ondrusova M, Spanikova B, Sevcikova K, Ondrus D (2018) Testosterone deficiency and bone metabolism damage in testicular cancer survivors. Am J Mens Health 12(3):628–633

    Article  Google Scholar 

  17. Glass AR, Swerdloff RS, Bray GA, Dahms WT, Atkinson RL (1977) Low serum testosterone and sex-hormone-binding-globulin in massively obese men. J Clin Endocrinol Metab 45(6):1211–1219

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Hematology and Oncology, Indiana University Melvin and Bren Simon Cancer Center, 535 Barnhill Drive, RT 473, Indianapolis, IN, 46202, USA

    N. Khanal, M. Kalra, T. J. Miller, M. J. Brames, N. H. Hanna & Lawrence H. Einhorn

  2. Larner College of Medicine, University of Vermont, Burlington, VT, 05405, USA

    S. S. Ahmed

  3. Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, USA

    T. E. Stump & P. Monahan

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  1. N. Khanal
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  2. S. S. Ahmed
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  3. M. Kalra
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Correspondence to Lawrence H. Einhorn.

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Conflict of interest

Dr. NH Hanna reports receiving grant support for research from Genentech, AstraZeneca, Merck, and Bristol Myers Squibb.

Dr. LH Einhorn owns stock in AMGEN and Biogenidec and is on scientific advisory board for Celgene.

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Khanal, N., Ahmed, S.S., Kalra, M. et al. The effects of hypogonadism on quality of life in survivors of germ cell tumors treated with surgery alone versus surgery plus platinum-based chemotherapy. Support Care Cancer 28, 3165–3170 (2020). https://doi.org/10.1007/s00520-019-05117-0

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  • DOI: https://doi.org/10.1007/s00520-019-05117-0

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