The effects of hypogonadism on quality of life in survivors of germ cell tumors treated with surgery alone versus surgery plus platinum-based chemotherapy

N. Khanal, S. S. Ahmed, M. Kalra, T. J. Miller, M. J. Brames, T. E. Stump, P. Monahan, N. H. Hanna, Lawrence H. Einhorn

Research output: Contribution to journalArticle

Abstract

Background: It is important to assess the prevalence of hypogonadism and to identify the correlation between hypogonadism and cancer treatment with quality of life (QoL) in germ cell tumor (GCT) survivors. Methods: This is a single-center, non-randomized, prospective observational study in GCT survivors 18–50 years of age previously treated with surgery and chemotherapy (S+C) or surgery alone (S). Patients completed a validated QoL questionnaire at baseline, 3, and 6 months. Patients received supplemental testosterone as clinically indicated. Mean QoL scores were compared between two treatment groups (S+C vs. S) and within each group between survivors with hypogonadism (serum testosterone level < 300 ng/dL) versus without. A two-sided independent-groups t test was used to compare means. Results: We evaluated 199 GCT survivors. At baseline, the prevalence of biochemical hypogonadism was 48% overall, 51% in S+C group, and 45% in S group (p =.4). Overall, there was no statistically significant difference in QoL scores between S+C and C groups, except the S+C group exhibited greater modified Aging Male Symptoms (AMS) at baseline and 6 months. Patients with hypogonadism reported more fatigue, poor sleep quality, and worse general health at baseline. There were no statistical differences in mean QOL scores between patients with testosterone < 300 ng/dL who received testosterone supplementation and who did not. Conclusion: A significant proportion of GCT survivors have low testosterone levels after platinum-based chemotherapy and surgery as well as with just surgery alone. GCT survivors treated with platinum-based chemotherapy exhibited more symptoms related to male aging compared with survivors treated with surgery alone.

Original languageEnglish (US)
Pages (from-to)3165-3170
Number of pages6
JournalSupportive Care in Cancer
Volume28
Issue number7
DOIs
StatePublished - Jul 1 2020

Keywords

  • Germ cell tumor survivorship
  • Hypogonadism
  • Platinum-based chemotherapy
  • Quality of life
  • Testosterone replacement

ASJC Scopus subject areas

  • Oncology

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