Adverse Health Outcomes in Relationship to Hypogonadism After Chemotherapy: A Multicenter Study of Testicular Cancer Survivors.
Abstract | BACKGROUND: PATIENTS AND METHODS: Eligible TCS were <55 years of age at diagnosis and treated with first-line platinum-based chemotherapy. Participants underwent physical examinations and completed questionnaires regarding 15 AHOs and health behaviors. Hypogonadism was defined as serum testosterone levels ≤3.0 ng/mL or use of testosterone replacement therapy. We investigated the role of 2 single nucleotide polymorphisms (rs6258 and rs12150660) in the sex hormone-binding globulin (SHBG) locus implicated in increased hypogonadism risk in the general population. RESULTS: Of 491 TCS (median age at assessment, 38.2 years; range, 18.7-68.4 years), 38.5% had hypogonadism. Multivariable binary logistic regression analysis identified hypogonadism risk factors, including age at clinical evaluation (odds ratio [OR], 1.42 per 10-year increase; P= .006) and body mass index of 25 to <30 kg/m2 (OR, 2.08; P= .011) or ≥30 kg/m2 (OR, 2.36; P= .005) compared with <25 kg/m2. TCS with ≥2 risk alleles for the SHBG SNPs had a marginally significant increased hypogonadism risk (OR, 1.45; P= .09). Vigorous-intensity physical activity appeared protective (OR, 0.66; P= .07). Type of cisplatin-based chemotherapy regimen and socioeconomic factors did not correlate with hypogonadism. Compared with TCS without hypogonadism, those with hypogonadism were more likely to report ≥2 AHOs (65% vs 51%; P= .003), to take medications for hypercholesterolemia (20.1% vs 6.0%; P<.001) or hypertension (18.5% vs 10.6%; P= .013), and to report erectile dysfunction (19.6% vs 11.9%; P= .018) or peripheral neuropathy (30.7% vs 22.5%; P= .041). A marginally significant trend for increased use of prescription medications for either diabetes (5.8% vs 2.6%; P= .07) or anxiety/depression (14.8% vs 9.3%; P= .06) was observed. CONCLUSIONS:
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Authors | Mohammad Abu Zaid, Paul C Dinh, Patrick O Monahan, Chunkit Fung, Omar El-Charif, Darren R Feldman, Robert J Hamilton, David J Vaughn, Clair J Beard, Ryan Cook, Sandra Althouse, Shirin Ardeshir-Rouhani-Fard, Howard D Sesso, Robert Huddart, Taisei Mushiroda, Michiaki Kubo, M Eileen Dolan, Lawrence H Einhorn, Sophie D Fossa, Lois B Travis, Platinum Study Group |
Journal | Journal of the National Comprehensive Cancer Network : JNCCN
(J Natl Compr Canc Netw)
Vol. 17
Issue 5
Pg. 459-468
(05 01 2019)
ISSN: 1540-1413 [Electronic] United States |
PMID | 31085753
(Publication Type: Journal Article, Multicenter Study, Research Support, N.I.H., Extramural)
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Topics |
- Adolescent
- Adult
- Aged
- Antineoplastic Combined Chemotherapy Protocols
(adverse effects, therapeutic use)
- Cancer Survivors
- Genetic Variation
- Humans
- Hypogonadism
(epidemiology, etiology, mortality)
- Male
- Middle Aged
- Neoplasm Staging
- Odds Ratio
- Patient Outcome Assessment
- Patient Reported Outcome Measures
- Risk Factors
- Testicular Neoplasms
(complications, diagnosis, drug therapy, mortality)
- Young Adult
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