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确定讨论影响睾丸癌患者的不孕问题的必要性:一项评估(INDICATE研究)。

Identifying the Need to Discuss Infertility Concerns Affecting Testicular Cancer Patients: An Evaluation (INDICATE Study).

作者信息

Krouwel Esmée M, Jansen Thijs G, Nicolai Melianthe P J, Dieben Sandra W M, Luelmo Saskia A C, Putter Hein, Pelger Rob C M, Elzevier Henk W

机构信息

Department of Urology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands.

Department of Medical Decision Making, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands.

出版信息

Cancers (Basel). 2021 Feb 1;13(3):553. doi: 10.3390/cancers13030553.

Abstract

Men with testicular cancer (TC) risk impaired fertility. Fertility is a major concern for TC patients due to diagnosis in almost always reproductive ages and high overall survival. This study assessed counselling in regards to the risk of impaired fertility and sperm cryopreservation. A cross-sectional survey was performed on 566 TC patients diagnosed between 1995-2015. Of the 566 survivors, 201 questionnaires were completed (35.5%). Eighty-eight percent was informed about possible impaired fertility, 9.5% was not informed. The majority (47.3%) preferred the urologist to provide information. Collecting sperm was troublesome but successful for 25.6%, 4.8% did not succeed in collecting sperm. The reasons were high pressure due to disease, pain after surgery and uncomfortable setting. Due to impaired fertility, 19% of the respondents reported grief and 9.3% stated as being less satisfied in life. Sperm cryopreservation was performed by 41.3% ( = 83). One third ( = 63, 31.3%) had children after treatment, of which 11.1% made use of preserved sperm ( = 7). The results of this survey indicate the importance of timely discussion of fertility issues with TC patients. While being discussed with most men, dissatisfaction and grief may occur as a result of impaired fertility and a lack of counselling. Overall, 6.5% made use of cryopreserved sperm ( = 13). Men prefer their urologist providing counselling on fertility.

摘要

睾丸癌(TC)男性患者存在生育能力受损风险。由于几乎所有患者均在生育年龄被诊断出患病且总体生存率较高,生育能力成为TC患者的主要担忧。本研究评估了关于生育能力受损风险及精子冷冻保存的咨询情况。对1995年至2015年间诊断出的566例TC患者进行了横断面调查。在566名幸存者中,201份问卷得以完成(35.5%)。88%的患者被告知可能存在生育能力受损情况,9.5%的患者未被告知。大多数患者(47.3%)希望泌尿科医生提供相关信息。采集精子虽有困难,但25.6%的患者成功采集到了精子,4.8%的患者未成功采集到精子。原因包括疾病带来的巨大压力、术后疼痛以及环境不适。由于生育能力受损,19%的受访者表示悲伤,9.3%的受访者称对生活的满意度降低。41.3%(n = 83)的患者进行了精子冷冻保存。三分之一(n = 63,31.3%)的患者在治疗后有了孩子,其中1

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