Dynamics of hormonal disorders following unilateral orchiectomy for a testicular tumor

Med Oncol. 2017 May;34(5):84. doi: 10.1007/s12032-017-0943-0. Epub 2017 Apr 7.

Abstract

Testicular tumors and their treatment interfere with homeostasis, hormonal status included. The aim of the study was to evaluate hormonal disorders of the pituitary-gonadal axis in men treated for testicular tumors. One hundred twenty-eight men treated for a unilateral testicular tumor at our institution were included. The hormonal status was prospectively evaluated in 62 patients before orchiectomy, 120 patients 1 month after orchiectomy and 110 patients at least 1 year after the treatment. The concentrations of human chorionic gonadotropin (hCG), testosterone (T), estradiol, luteinizing hormone (LH), follicle-stimulating hormone (FSH) and prolactin were measured. The clinically significant testosterone deficiency was defined either as testosterone <2.31 ng/mL or testosterone within the range of 2.31-3.46 ng/mL but simultaneous with T/LH ratio ≤1. Changes in hormone levels were significant: LH and FSH rose in the course of observation, and the concentration of hCG, testosterone, estradiol decreased. PRL concentration was the lowest at 1 month after orchiectomy. In multivariate analysis, the risk of the clinically significant testosterone deficiency was 0.2107 (95% CI 0.1206-0.3419) prior to orchiectomy, 0.3894 (95% CI 0.2983-0.4889) 1 month after surgery and 0.4972 (95% CI 0.3951-0.5995) 1 year after the treatment. The estradiol concentration was elevated in 40% of patients with recently diagnosed testicular cancer and that was correlated with a higher risk of testosterone deficiency after the treatment completion. Hormonal disorders of the pituitary-gonadal axis in men treated for testicular tumors are frequent. The malignant tissue triggers paraneoplastic disorders that additionally disturb the hormonal equilibrium.

Keywords: Hormones; Orchiectomy; Testicular tumor; Testosterone.

MeSH terms

  • Adolescent
  • Adult
  • Chorionic Gonadotropin / metabolism
  • Estradiol / metabolism
  • Follicle Stimulating Hormone / metabolism
  • Gonadal Hormones / metabolism*
  • Humans
  • Luteinizing Hormone / metabolism
  • Male
  • Middle Aged
  • Orchiectomy / adverse effects*
  • Orchiectomy / methods
  • Pituitary Gland / metabolism
  • Pituitary Hormones / metabolism*
  • Prolactin / metabolism
  • Testicular Neoplasms / surgery*
  • Testis / metabolism
  • Testosterone / deficiency
  • Testosterone / metabolism
  • Young Adult

Substances

  • Chorionic Gonadotropin
  • Gonadal Hormones
  • Pituitary Hormones
  • Testosterone
  • Estradiol
  • Prolactin
  • Luteinizing Hormone
  • Follicle Stimulating Hormone