OUS, The Norwegian Radium Hospital, Oslo, Norway
Mette Sprauten , Marianne Brydoy , Hege Sagstuen Haugnes , Carl Wilhelm Langberg , Olav Dahl , Olbjorn Harald Klepp , Roy M. Bremnes , Milada Cvancarova , Sophie D. Fossa , Jan Oldenburg
Background: Hypogonadism, i.e., low T-, high LH- and/or FSH-levels, is frequently observed in TCSs and is associated with cardiovascular disease, osteoporosis and reduced quality of life. Little is known about the impact of aging on hypogonadism in TCSs. Methods: T, LH, and FSH levels were retrieved twice from 874 TCSs median 11 (S11) and 19 (S19) years after orchiectomy and categorized based on cut-offs calculated from 570 healthy controls (C), separately for each decadal age group. Treatment was categorized into surgery (S), radiotherapy (RT) or cisplatin-based chemotherapy (CT). Impact of treatment and aging on T, LH and FSH levels was assessed by comparing proportions of TCSs grouped into the C quartiles by ordinal logistic regression and expressed with odds ratios (OR) and 95% confidence interval (CI). Results: TCSs had lower T and higher LH and FSH levels than C at S11 and S19 (p<0.05, except for LH after S at S11) (Table).Approximately 50% of TCSs had T levels in the lowestquartile at S11 and S19. The proportion of TCSs with T below the 2.5% cut-off threshold for C increased from S11 to S19, for the S (9.7 - 12.5%), RT (9.4 - 16.3%) and CT group (12.5- 19.9%). Conclusions: TCSs had lower T and higher LH and FSH levels than C of similar age indicating an impact of treatment. Importantly, proportions of TCSs in the highest LH quartile and below the 2.5% cut-off for T-level increased from S11 to S19, indicating an accelerated hormonal aging. Continued follow-up of hormone levels is important.
TCSs: n=874 | S: n=176, (100%) | RT: n=362, (100%) | CT: n=336, (100%) | |
---|---|---|---|---|
S11 | T in lowest quartile | 80 (46) | 190 (53) | 184 (55) |
OR(95%CI) | 2.6 (1.9- 3.5) | 3.3 (2.6- 4.3) | 3.6 (2.8 - 4.7) | |
LH in highest quartile | 58 (33) | 150 (41) | 173 (52) | |
OR(95%CI) | 1.2 (0.9- 1.6) | 2.0 (1.6- 2.5) | 2.7 (2.1- 3.4) | |
FSH in highest quartile | 146 (83) | 293 (81) | 292 (87) | |
OR(95%CI) | 15.6 (10.1 – 24.0) | 13.5 (9.8- 18.5) | 21.1 (14.7- 30.4) | |
S19 | T in lowest quartile | 81 (46) | 201 (56) | 193 (57) |
OR(95%CI) | 2.5 (1.8- 3.4) | 3.9 (3.0- 5.0) | 3.8 (3.0- 5.0) | |
LH in highest quartile | 90 (51) | 207 (57) | 200 (60) | |
OR(95%CI) | 3.2 (2.3- 4.4) | 4.0 (3.1- 5.2) | 4.5 (3.5- 5.9) | |
FSH in highest quartile | 149 (85) | 296 (82) | 293 (87) | |
OR(95%CI) | 17.4 (11.1 – 27.1) | 14.4 (10.4 – 19.7) | 21.4 (14.8 – 30.7) |
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