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Sperm count in Swedish clinical stage I testicular cancer patients following adjuvant treatment

Weibring, K.; Nord, C.; Ståhl, O. LU ; Eberhard, J. LU ; Sandberg, K.; Johansson, H.; Arver, S.; Giwercman, A. LU and Cohn-Cedermark, G. (2019) In Annals of oncology : official journal of the European Society for Medical Oncology 30(4). p.604-611
Abstract

BACKGROUND: Little is known regarding sperm production following adjuvant treatment in testicular cancer (TC) clinical stage I (CS I) patients. PATIENTS AND METHODS: A total of 182 TC patients aged 18-50 years were prospectively included during 2001-2006 at any given time within 5 years of orchiectomy. Semen samples were delivered postorchiectomy but before further treatment, 6, 12, 24, 36 and 60 months (T0-T60) after completed therapy. Total sperm number (TSN) and sperm concentration (SC) were used as measurements of testicular function. Four groups according to treatment modality were identified; Radiotherapy; To a total dose of 25.2 Gy to the infradiaphragmal paraaortic and ipsilateral iliac lymph nodes (RT, N = 70), one cycle of... (More)

BACKGROUND: Little is known regarding sperm production following adjuvant treatment in testicular cancer (TC) clinical stage I (CS I) patients. PATIENTS AND METHODS: A total of 182 TC patients aged 18-50 years were prospectively included during 2001-2006 at any given time within 5 years of orchiectomy. Semen samples were delivered postorchiectomy but before further treatment, 6, 12, 24, 36 and 60 months (T0-T60) after completed therapy. Total sperm number (TSN) and sperm concentration (SC) were used as measurements of testicular function. Four groups according to treatment modality were identified; Radiotherapy; To a total dose of 25.2 Gy to the infradiaphragmal paraaortic and ipsilateral iliac lymph nodes (RT, N = 70), one cycle of adjuvant BEP (bleomycin, etoposide, cisplatin, 5 day regimen) (BEP, N = 62), one cycle of adjuvant carboplatin AUC 7 (Carbo, N = 22), and patients managed by surveillance (SURV, N = 28). RESULTS: In the cross-sectional analysis, a significant but transient drop in mean TSN and mean SC (T0-T60) was seen at T6 after radiotherapy. Apart from a significant increase in mean SC at T12 compared with baseline, no significant differences were observed in the other treatment groups. In 119 patients delivering 3 or more samples, values in TSN and SC were rather stable over time. Azoospermic patients (N = 11) were observed in most treatment groups except for in the BEP group. During follow-up, one azoospermic patient belonging to the Carbo group became normospermic. CONCLUSIONS: No clinically significant long-term effect on TSN or SC associated with adjuvant treatment in TC CSI patients was found. However, as patients may have low sperm counts before orchiectomy as well as after adjuvant treatment, we offer sperm banking before orchiectomy as assisted reproductive measures may be necessary regardless of treatment given.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
adjuvant treatment, chemotherapy, sperm concentration, testicular cancer, total sperm number
in
Annals of oncology : official journal of the European Society for Medical Oncology
volume
30
issue
4
pages
8 pages
publisher
Oxford University Press
external identifiers
  • scopus:85066863450
ISSN
1569-8041
DOI
10.1093/annonc/mdz017
language
English
LU publication?
yes
id
395a3a75-25ac-4a11-94fe-7821ab0180ad
date added to LUP
2019-06-19 09:47:37
date last changed
2019-07-09 04:48:37
@article{395a3a75-25ac-4a11-94fe-7821ab0180ad,
  abstract     = {<p>BACKGROUND: Little is known regarding sperm production following adjuvant treatment in testicular cancer (TC) clinical stage I (CS I) patients. PATIENTS AND METHODS: A total of 182 TC patients aged 18-50 years were prospectively included during 2001-2006 at any given time within 5 years of orchiectomy. Semen samples were delivered postorchiectomy but before further treatment, 6, 12, 24, 36 and 60 months (T0-T60) after completed therapy. Total sperm number (TSN) and sperm concentration (SC) were used as measurements of testicular function. Four groups according to treatment modality were identified; Radiotherapy; To a total dose of 25.2 Gy to the infradiaphragmal paraaortic and ipsilateral iliac lymph nodes (RT, N = 70), one cycle of adjuvant BEP (bleomycin, etoposide, cisplatin, 5 day regimen) (BEP, N = 62), one cycle of adjuvant carboplatin AUC 7 (Carbo, N = 22), and patients managed by surveillance (SURV, N = 28). RESULTS: In the cross-sectional analysis, a significant but transient drop in mean TSN and mean SC (T0-T60) was seen at T6 after radiotherapy. Apart from a significant increase in mean SC at T12 compared with baseline, no significant differences were observed in the other treatment groups. In 119 patients delivering 3 or more samples, values in TSN and SC were rather stable over time. Azoospermic patients (N = 11) were observed in most treatment groups except for in the BEP group. During follow-up, one azoospermic patient belonging to the Carbo group became normospermic. CONCLUSIONS: No clinically significant long-term effect on TSN or SC associated with adjuvant treatment in TC CSI patients was found. However, as patients may have low sperm counts before orchiectomy as well as after adjuvant treatment, we offer sperm banking before orchiectomy as assisted reproductive measures may be necessary regardless of treatment given.</p>},
  author       = {Weibring, K. and Nord, C. and Ståhl, O. and Eberhard, J. and Sandberg, K. and Johansson, H. and Arver, S. and Giwercman, A. and Cohn-Cedermark, G.},
  issn         = {1569-8041},
  keyword      = {adjuvant treatment,chemotherapy,sperm concentration,testicular cancer,total sperm number},
  language     = {eng},
  number       = {4},
  pages        = {604--611},
  publisher    = {Oxford University Press},
  series       = {Annals of oncology : official journal of the European Society for Medical Oncology},
  title        = {Sperm count in Swedish clinical stage I testicular cancer patients following adjuvant treatment},
  url          = {http://dx.doi.org/10.1093/annonc/mdz017},
  volume       = {30},
  year         = {2019},
}