Kim Grace Y, Conduit Ciara, O'Haire Sophie, Chong Chia Yuen, Baenziger Olivia, Lewin Jeremy, Thomas Benjamin, Lawrentschuk Nathan, Stockler Martin R, Olver Ian, Grimison Peter, Tran Ben
Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia.
Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
Basic Clin Androl. 2024 Sep 3;34(1):14. doi: 10.1186/s12610-024-00230-5.
Primary hypogonadism is a recognised complication in survivors of testicular cancer. However, secondary hypogonadism can result from other causes that suppress the hypothalamic-pituitary axis, including obesity, high dose glucocorticoids, chronic end organ failure, and diabetes. The aim of this study was to explore low total serum testosterone in Australian survivors of testicular cancer and examine associations with body mass index, age, and prior chemotherapy use.
Clinical data including height, weight, diagnosis, treatment, and hormonal evaluations during follow-up were extracted from the Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group Chemocog study (2007-2012), accompanied by data from two Australian, high-volume testicular cancer centres included in the iTestis testicular cancer registry (2012-2019). Low testosterone was defined by a serum concentration of testosterone (T) < 10 nmol/L, and was classified as primary by a serum concentration of luteinising hormone (LH) > 8 IU/L, otherwise as secondary.
Two hundred eighty-five individuals with either stage 1 or advanced testicular cancer were included. Of these, 105 (37%) were treated with orchidectomy and chemotherapy. Forty-nine (17%) met criteria for low testosterone during follow-up: 21 (43%) had primary and 27 (55%) had secondary low testosterone. Survivors of testicular cancer with higher body mass index were more likely to display low testosterone, both primary (p = 0.032) and secondary (p = 0.028). Our data did not show evidence of an association between older age or chemotherapy use and low testosterone in our cohort.
Low total serum testosterone was common in survivors of testicular cancer, and associated with a higher body mass index prior to orchidectomy, suggesting that elevated body mass index may contribute to low testosterone in this population, and that body weight, diet, and exercise should be addressed in testicular cancer follow-up.
原发性性腺功能减退是睾丸癌幸存者中一种公认的并发症。然而，继发性性腺功能减退可能由其他抑制下丘脑 - 垂体轴的原因引起，包括肥胖、高剂量糖皮质激素、慢性终末器官衰竭和糖尿病。本研究的目的是探讨澳大利亚睾丸癌幸存者血清总睾酮水平低的情况，并研究其与体重指数、年龄和既往化疗使用情况之间的关联。
从澳大利亚和新西兰泌尿生殖系统及前列腺（ANZUP）癌症试验组的Chemocog研究（2007 - 2012年）中提取临床数据，包括身高、体重、诊断、治疗及随访期间的激素评估数据，同时纳入来自iTestis睾丸癌登记处（2012 - 2019年）的两个澳大利亚大型睾丸癌中心的数据。睾酮水平低定义为血清睾酮（T）浓度<10 nmol/L，若促黄体生成素（LH）血清浓度>8 IU/L则分类为原发性，否则为继发性。
纳入了285例I期或晚期睾丸癌患者。其中，105例（37%）接受了睾丸切除术和化疗。49例（17%）在随访期间符合睾酮水平低的标准：21例（43%）为原发性，27例（55%）为继发性睾酮水平低。体重指数较高的睾丸癌幸存者更有可能出现睾酮水平低的情况，原发性（p = 0.032）和继发性（p = 0.028）均如此。我们的数据未显示年龄较大或使用化疗与我们队列中睾酮水平低之间存在关联的证据。
血清总睾酮水平低在睾丸癌幸存者中很常见，且与睾丸切除术前较高的体重指数相关，这表明体重指数升高可能导致该人群睾酮水平低，在睾丸癌随访中应关注体重、饮食和运动问题。
