کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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3924429 | 1253102 | 2010 | 8 صفحه PDF | دانلود رایگان |
BackgroundPreserved fertility is an important issue for testicular cancer (TC) survivors.ObjectiveOur aim was to examine any difference regarding paternity and testicular function following two, three, or four cycles of cisplatin-based chemotherapy for TC.Design, setting, and participantsA national multicentre follow-up survey assessing morbidity among survivors of unilateral TC diagnosed from 1980 to 1994 was conducted during the period 1998 to 2002. Of the 1814 men invited, 1462 (80.6%) participated by responding to a mailed questionnaire and/or undergoing a clinical examination including laboratory assessments. The present study includes the 316 participants up to 65 yr of age treated with two to four cycles of standard cisplatin-based chemotherapy without additional treatment beyond surgery.MeasurementsSelf-reported paternity following treatment for TC according to number of cycles was assessed among men who reported antegrade ejaculation and attempts at posttreatment conception (n = 106). Kaplan-Meier analysis, log-rank test, and Cox regression were applied. Gonadal hormones (n = 305–314) and sperm counts (n = 71) by number of cycles were assessed by linear by linear association or Mann-Whitney tests.Results and limitationsAt median 12-yr follow-up, 80% (85 of 106) had succeeded in their attempts of achieving posttreatment paternity (two cycles: 100%; three: 83%; four: 76%; p = 0.022). For all patients the 15-yr actuarial paternity rate was 85%. The association between posttreatment paternity and number of cycles remained significant in the multivariate analysis (p = 0.032). High serum follicle-stimulating hormone values were more common with increasing number of cycles (p = 0.037), but there were no differences in serum luteinising hormone, serum testosterone, or sperm counts. Few men treated with two cycles and a limited number of sperm samples are the main limitations of this study.ConclusionsThe prospects of future paternity after two to four cycles of cisplatin-based chemotherapy are good, and our data suggest that the prospects improve with decreasing number of cycles.
Journal: European Urology - Volume 58, Issue 1, July 2010, Pages 134–141