Risk factors for post-treatment hypogonadism in testicular cancer patients.

Objectives: Testicular germ-cell cancer (TGCC) patients are at risk of developing hypogonadism but no risk factors have yet been defined. Methods: Blood was collected from 143 TGCCpatients (after orchidectomy, prior to further therapy (T0) and6,12,24,36and60months(T6,T12,T24,T36andT60)after therapy).Biologicalhypogonadism (BH) was defined as: serum testosterone below 10 nmol/l and/or LH O10 IU/l; odds ratios (ORs) for BH with BH at T0, age, stage of disease, testicular characteristics, and androgen receptor polymorphism as predictors were calculated as well as the OR for developing BH post-treatment (one to two cycles of adjuvant chemotherapy (ACT) versus three to four cycles of higher dose chemotherapy (HCT) versus adjuvant radiotherapy (RT)). Results:HCTincreasedtheORforBHatT6(OR22,95%confidenceinterval(CI)4.4‐118)andT12(OR 5.8, 95% CI 1.5‐22). RT increased the OR at T6 (OR 10, 95% CI 2.1‐47) and at T12 (OR 3.9, 95% CI 1.1‐14).MicrolithiasispredictedBHatT0(OR11,95%CI1.2‐112),T12(OR3.9,95%CI1.1‐13),T24 (OR 3.0, 95% CI 1.0‐8.8), T36 (OR 5.4, 95% CI 1.7‐17) and T60 (OR 4.4, 95% CI 1.2‐16). BH at T0 was a risk for BH at T6 (OR 53, 95% CI 19‐145), T12 (OR 125, 95% CI 37‐430), T24 (OR 88, 95% CI 26‐300) and T36 (OR 121, 95% CI 32‐460). Conclusions: It is clinically relevant that BH at T0 and testicular microlithiasis were predictive factors for post-treatment BH. HCT and RT gave temporary BH.