Necessity of Hormonal and Osteological Examination in Testicular Cancer Long Term Survivors

1
Necessity of Hormonal and Osteological
Examination in Testicular Cancer Long Term
Survivors

• Dalibor Ondru
• Bratislava
• Slovak Republic

2
Introduction and Aims

• Improved survival of testicular cancer patients
• Rising interest on the disease consequences of
  whole
• the organism (late toxicity)
• Documented impact of the therapeutical modalities
  on
• hormone status and bone metabolism
• Patients with bilateral and unilateral testicular
  cancer
• Hormone profile examination and complete
  osteological examination
• Algorithm of follow-up in testicular cancer
  patients

3
Material

• Prospective study carried out between
  11/2005-4/2008
• included 816 followed-up patients with
  testicular cancer
• after orchiectomy
• mean 108 months (9 years) , median
  90months (7,5 years) range 3-453 months
• Therapy following orchiectomy surveillance
• 
  chemotherapy
• 
  radiotherapy
  
• 
  both
  
• Unilateral testicular cancer
  (Group A) 764 pts
• Bilateral testicular cancer
  (Group B) 52 pts
• 
  

4
Methods

• Follow-up of patients with
• unilateral
  testicular cancer (group A)
• bilateral
  disease (group B)
• Examination of hormone profile -
• serum
  testosterone
• LH levels
• Osteological examination -
• marker of bone resorption S-CTx
  
• (serum C-terminal cross-linking
  telopeptides of type I collagen)
  
• serum calcium levels
• dual energy photon x-ray absorptiometry
  (DXA)
• 
  measurement of bone mineral density (BMD)

5
Results (1)

• Testosterone deficiency Normal range (gt10.0
  nmol/l)
• Detected in 31/764 (4.1 ) pts (A)
• 44/52 (84.6 )
  pts (B) plt0.001
• Elevated S-CTx Normal range (1020-3750 pM)
• Detected in 378/764 (49.5 ) pts (A)
• 32/52 (61.5 )
  pts (B) no significant difference
• Increased LH Normal range (1.8-8.2 mU/ml)
• Detected in 114/764 (14.9 ) pts (A)
• 42/52 (80.8
  ) pts (B) plt0.001
• Bone densitometry (BMD) osteopenia,
  osteoporosis
• Detected in 384/764 (50.3 ) pts (A)
• 37/52 (71.1 )
  pts (B) plt0.05
• Serum Calcium levels in all patients in normal
  range

6
Conclusions

• Preliminary unpublished results
• Important aspect of patient's follow-up
• - hormone profile examination and
  osteological examination
• Prevention
• - damage of bone metabolism (osteopenia,
  osteoporosis develop.)
• - hormonal deficiency
• Recommendation as the standard examination
  algorithm
• not only in bilateral TC, but also in
  unilateral TC, with impact on
• whole the organism (not only with
  consideration to the patient's
• sexual life)