Surgery With or Without Chemo Yields Low Testosterone in GCT Survivors

A significant percentage of survivors of germ-cell tumors (GCTs) had low testosterone levels after undergoing surgery whether or not they also received platinum-based chemotherapy, study results have shown. However, platinum-based chemotherapy led to more symptoms tied to male aging in this setting (Support Care Cancer. 2019 Nov 9. Epub ahead of print).

“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 [survivors of GCTs],” explained Nabin Khanal, MD, Hematology and Oncology, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, and colleagues.

Thus, Dr Khanal et al conducted a single-center, nonrandomized, prospective observational study of 199 adult survivors of GCT who previously underwent surgery with or without receipt of chemotherapy.

Participants were asked to finish a validated QoL questionnaire at baseline, 3 months, and 6 months, the mean scores of which were then compared between the 2 treatment arms and within each individual arm between those  with (ie, serum testosterone level <300 ng/dL) and without hypogonadism.

Overall, the prevalence of biochemical hypogonadism at baseline was 48%, with 51% and 45% in the surgery plus chemotherapy and surgery alone arms, respectively (P = .4). Results demonstrated no statistically significant difference in QoL scores between the 2 treatment arms; however, survivors who were in the surgery plus chemotherapy arm had greater modified Aging Male Symptoms (AMS) at baseline and 6 months.

Furthermore, survivors with hypogonadism were more likely to report fatigue, poor sleep quality, and worse general health at baseline than those without hypogonadism. Notably, there were no statistical differences in mean QOL scores between individuals with hypogonadism who did and did not receive testosterone supplementation.

“A significant proportion of GCT survivors have low testosterone levels after platinum-based chemotherapy and surgery as well as with just surgery alone,” Dr Khanal and colleagues said.

“GCT survivors treated with platinum-based chemotherapy exhibited more symptoms related to male aging compared with survivors treated with surgery alone,” they concluded.—Hina Porcelli