European urology · 2010
Paternity and testicular function among testicular cancer survivors treated with two to four cycles of cisplatin-based chemotherapy.
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Brydøy Marianne, Fosså Sophie D, Klepp Olbjørn, Bremnes Roy M, Wist Erik A, Wentzel-Larsen Tore, Dahl Olav, Norwegian Urology Cancer Group III study group
Аннотация
BACKGROUND: Preserved fertility is an important issue for testicular cancer (TC) survivors.
OBJECTIVE: Our aim was to examine any difference regarding paternity and testicular function following two, three, or four cycles of cisplatin-based chemotherapy for TC.
DESIGN, SETTING, AND PARTICIPANTS: A national multicentre follow-up survey assessing morbidity among survivors of unilateral TC diagnosed from 1980 to 1994 was conducted during the period 1998 to 2002. Of the 1814 men invited, 1462 (80.6%) participated by responding to a mailed questionnaire and/or undergoing a clinical examination including laboratory assessments. The present study includes the 316 participants up to 65 yr of age treated with two to four cycles of standard cisplatin-based chemotherapy without additional treatment beyond surgery.
MEASUREMENTS: Self-reported paternity following treatment for TC according to number of cycles was assessed among men who reported antegrade ejaculation and attempts at posttreatment conception (n=106). Kaplan-Meier analysis, log-rank test, and Cox regression were applied. Gonadal hormones (n=305-314) and sperm counts (n=71) by number of cycles were assessed by linear by linear association or Mann-Whitney tests.
RESULTS AND LIMITATIONS: At median 12-yr follow-up, 80% (85 of 106) had succeeded in their attempts of achieving posttreatment paternity (two cycles: 100%; three: 83%; four: 76%; p=0.022). For all patients the 15-yr actuarial paternity rate was 85%. The association between posttreatment paternity and number of cycles remained significant in the multivariate analysis (p=0.032). High serum follicle-stimulating hormone values were more common with increasing number of cycles (p=0.037), but there were no differences in serum luteinising hormone, serum testosterone, or sperm counts. Few men treated with two cycles and a limited number of sperm samples are the main limitations of this study.
CONCLUSIONS: The prospects of future paternity after two to four cycles of cisplatin-based chemotherapy are good, and our data suggest that the prospects improve with decreasing number of cycles.
OBJECTIVE: Our aim was to examine any difference regarding paternity and testicular function following two, three, or four cycles of cisplatin-based chemotherapy for TC.
DESIGN, SETTING, AND PARTICIPANTS: A national multicentre follow-up survey assessing morbidity among survivors of unilateral TC diagnosed from 1980 to 1994 was conducted during the period 1998 to 2002. Of the 1814 men invited, 1462 (80.6%) participated by responding to a mailed questionnaire and/or undergoing a clinical examination including laboratory assessments. The present study includes the 316 participants up to 65 yr of age treated with two to four cycles of standard cisplatin-based chemotherapy without additional treatment beyond surgery.
MEASUREMENTS: Self-reported paternity following treatment for TC according to number of cycles was assessed among men who reported antegrade ejaculation and attempts at posttreatment conception (n=106). Kaplan-Meier analysis, log-rank test, and Cox regression were applied. Gonadal hormones (n=305-314) and sperm counts (n=71) by number of cycles were assessed by linear by linear association or Mann-Whitney tests.
RESULTS AND LIMITATIONS: At median 12-yr follow-up, 80% (85 of 106) had succeeded in their attempts of achieving posttreatment paternity (two cycles: 100%; three: 83%; four: 76%; p=0.022). For all patients the 15-yr actuarial paternity rate was 85%. The association between posttreatment paternity and number of cycles remained significant in the multivariate analysis (p=0.032). High serum follicle-stimulating hormone values were more common with increasing number of cycles (p=0.037), but there were no differences in serum luteinising hormone, serum testosterone, or sperm counts. Few men treated with two cycles and a limited number of sperm samples are the main limitations of this study.
CONCLUSIONS: The prospects of future paternity after two to four cycles of cisplatin-based chemotherapy are good, and our data suggest that the prospects improve with decreasing number of cycles.
Предметные рубрики MeSH
AdultAntineoplastic AgentsAntineoplastic Combined Chemotherapy ProtocolsCisplatinEjaculationFertilizationFollicle Stimulating HormoneFollow-Up StudiesGerminomaHealth SurveysHumansInfertility, MaleLuteinizing HormoneMaleMiddle AgedMulticenter Studies as TopicOrchiectomyPaternitySperm CountSurvivorsTesticular NeoplasmsTestisTestosteroneYoung Adult