Introduction
Materials and methods
-
directly before orchiectomy (if the patient was referred prior to surgery),
-
one month after orchiectomy,
-
at least 1 year after the completion of treatment. Patients with progressive disease after the first-line treatment were excluded from the analysis at control points 2 and 3.
Participants | 128 men |
Patients’ age (median) | 18–63 years (31 years) |
Analyzed | |
First control point | 62 patients |
Second control point | 120 patients |
Third control point | 110 patients |
Histology of the primary testicular tumor | |
Seminoma | 59 patients |
Non-seminoma | 67 patients |
Seminoma component present | 14 patients |
Ca. embryonale component present | 56 patients |
Choriocarcinoma component present | 12 patients |
Yolk sac tumor component present | 27 patients |
Teratoma immaturum component present | 12 patients |
Teratoma maturum component present | 22 patients |
Leydig cell tumor | 2 patients |
Clinical stage | |
IA | 59 patients |
IB | 15 patients |
IS | 5 patients |
IIA | 16 patients |
IIB | 2 patients |
IIC | 2 patients |
IIIA | 13 patients |
IIIB | 8 patients |
IIIC | 8 patients |
Treatment methods | |
Unilateral orchiectomy | 128 patients |
Chemotherapy | 70 patients |
Radiotherapy | 16 patients |
Retroperitoneal lymph node dissection | 11 patients |
Results
Changes in hormone concentrations over time
Control point | Minimum | Maximum | Median | Number of patients with values above normal limits | Number of patients with values below normal limits |
---|---|---|---|---|---|
Chorionic gonadotropin (mIU/mL) | |||||
1. | 0 | 533.390 | 1.95 | 26/62 (42%) | 0 |
2. | 0.1 | 549.893 | 0.1 | 23/120 (19%) | 0 |
3. | 0.1 | 4.1 | 0.1 | 0/110 | 0 |
Prolactin (ng/mL) | |||||
1. | 3.80 | 34.60 | 8.55 | 2/58 (4%) | 2/58 (3%) |
2. | 2.80 | 21.90 | 7.6 | 1/117 (1%) | 15/117 (13%) |
3. | 3.55 | 21.1 | 9.7 | 0/110 | 4/110 (3%) |
Estradiol (pg/mL) | |||||
1. | 5.00 | 2228.00 | 34.2 | 22/57 (39%) | 1/57 (2%) |
2. | 4.00 | 2333.00 | 27.00 | 18/115 (16%) | 2/115 (2%) |
3. | 5.00 | 101.70 | 22.91 | 7/110 (6%) | 9/110 (8%) |
Follicle-stimulating hormone (mIU/mL) | |||||
1. | 0.10 | 29.40 | 4.96 | 6/58 (10%) | 22/58 (38%) |
2. | 0.10 | 58.40 | 11.1 | 37/120 (31%) | 18/120 (15%) |
3. | 0.20 | 66.31 | 16.79 | 55/110 (50%) | 3/110 (3%) |
Luteinizing hormone (mIU/mL) | |||||
1. | 0.10 | 13.70 | 2.9 | 5/58 (9%) | 23/58 (40%) |
2. | 0.10 | 27.20 | 6.51 | /120 (%) | 18/120 (15%) |
3. | 0.10 | 135.00 | 7.01 | 43/110 (39%) | 4/110 (4%) |
Testosterone (ng/mL) | |||||
1. | 1.10 | 15.00 | 5.05 | 12/58 (21%) | <2.31: 3/58 (5%) ≥2.31 and ≤3.46: 10/58 (17%) |
2. | 0.60 | 10.30 | 3.8 | 6/120 (5%) | <2.31: 19/120 (16%) ≥2.31 and ≤3.46: 32/120 (27%) |
3. | 1.30 | 12.00 | 3.59 | 2/110 (2%) | <2.31: 19/110 (17%) ≥2.31 and ≤3.46: 33/110 (30%) |
The risk of testosterone deficiency
The correlation between hormone concentrations
LH | FSH | Testosterone | Estradiol | HCG | PRL | |
---|---|---|---|---|---|---|
Active disease
| ||||||
First control point—before orchiectomy | ||||||
LH | 1.0 |
0.92393
|
−0.63824
|
−0.64714
|
−0.67406
|
−0.36690 |
FSH |
0.92393
| 1.0 |
−0.64079
|
−0.79251
|
−0.72811
|
−0.48402 |
Testosterone |
−0.63824
|
−0.64079
| 1.0 |
0.63215
|
0.62279
| 0.40277 |
Estradiol |
−0.64714
|
−0.79251
|
0.63215
| 1.0 |
0.84003
|
0.66343
|
HCG |
−0.67406
|
−0.72811
|
0.62279
|
0.84003
| 1.0 |
0.56137
|
PRL |
−0.36690 |
−0.48402 | 0.40277 |
0.66343
|
0.56137
| 1.0 |
Second control point—1 month after orchiectomy—patients with active disease | ||||||
LH | 1.0 |
0.93580
|
−0.25795 |
−0.51236
|
−0.65898
|
−0.28004 |
FSH |
0.93580
| 1.0 |
−0.38360 |
−0.63227
|
−0.75261
|
−0.30979 |
Testosterone |
−0.25795 |
−0.38360 | 1.0 |
0.61473
| 0.35639 | 0.30749 |
Estradiol |
−0.51236
|
−0.63227
|
0.61473
| 1.0 |
0.68578
| 0.30295 |
HCG |
−0.65898
|
−0.75261
| 0.35639 |
0.68578
| 1.0 | 0.25110 |
PRL |
−0.28004 |
−0.30979 | 0.30749 |
0.69001
| 0.25110 | 1.0 |
Free of disease
| ||||||
Second control point—1 month after orchiectomy—patients free of disease | ||||||
LH | 1.0 |
0.83210
|
−0.09518 |
−0.31178 |
−0.47824 |
−0.05733 |
FSH |
0.83210
| 1.0 |
−0.13473 |
−0.30350 |
−0.47802 |
−0.10608 |
Testosterone |
−0.09518 |
−0.13473 | 1.0 | 0.24555 | 0.12947 | 0.03140 |
Estradiol |
−0.31178 |
−0.30350 | 0.24555 | 1.0 | 0.42551 | 0.14004 |
HCG |
−0.47824 |
−0.47802 | 0.12947 | 0.42551 | 1.0 | 0.22823 |
PRL |
−0.05733 |
−0.10608 | 0.03140 | 0.14004 | 0.22823 | 1.0 |
Third control point—1 year after treatment completion | ||||||
LH | 1.0 |
0.83956
|
−0.12871 |
−0.19528 | 0.06883 | 0.08902 |
FSH |
0.83956
| 1.0 |
−0.18038 |
−0.21381 | 0.09891 | 0.04118 |
Testosterone |
−0.12871 |
−0.18038 | 1.0 | 0.52583 |
−0.11595 | 0.24094 |
Estradiol |
−0.19528 |
−0.21381 | 0.52583 | 1.0 |
−0.20111 | 0.07692 |
HCG | 0.06883 | 0.09891 |
−0.11595 |
−0.20111 | 1.0 | 0.14737 |
PRL | 0.08902 | 0.04118 | 0.24094 | 0.07692 | 0.14737 | 1.0 |