Hypogonadism and Sexual Dysfunction in Testicular Tumor Survivors: A Systematic Review

Vignera, Sandro La; Cannarella, Rossella; Duca, Ylenia; Barbagallo, Federica; Burgio, Giovanni; Compagnone, Michele; Cataldo, Andrea Di; Calogero, Aldo E.; Condorelli, Rosita A.

doi:10.3389/fendo.2019.00264

Cited by 27 publications

(30 citation statements)

References 59 publications

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“…However, most of the previous studies were conducted without comparison of groups. In addition, multiple tools were used to assess erection function in different studies, which made comparison of the results a great chal- 2 Arch Med Sci lenge. Moreover, a systematic review including 36 studies demonstrated that male erectile disorder occurred in 11.5% of TC survivors [10].…”

Section: Introductionmentioning

confidence: 99%

Erectile dysfunction in testicular cancer survivors: a meta-analysis of case-control studies

et al. 2020

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Introduction: Testicular cancer (TC) is the most frequent cancer among men aged 14-44 years. The risk of erectile dysfunction (ED) in TC patients varied within a wide range across different studies. This study aims to estimate the risk of ED in TC patients by conducting a meta-analysis of case-control studies. Material and methods: Relevant studies were searched using PubMed, EMBASE, Scopus, and the Cochrane Library up to June 2019. Case-control studies that reported the incidence of ED in TC patients were included. Results: A total of 8 studies involving 2060 TC patients and 2651 healthy men were included. All the TC patients underwent unilateral orchiectomy; other treatment modalities were also conducted if necessary. ED occurred in 16.9% (348/2060) of TC patients and 9.4% (251/2651) of healthy men. Compared with healthy men, TC patients experienced a significantly increased risk of ED (OR = 2.39, 95% CI: 1.56-3.67). Substantial heterogeneity was observed. In addition, subgroup analysis revealed that the risk (OR = 3.76, 95% CI: 2.45-5.78) for ED in TC patients with follow-up < 5 years was significantly higher than that (OR = 1.61, 95% CI: 1.10-3.67) with follow-up ≥ 5 years. Heterogeneity was improved after subgroup analysis. Conclusions: TC patients experienced an increased risk for ED compared with healthy men. The long-term risk for ED in TC patients was lower than the short-term risk.

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Section: Introductionmentioning

confidence: 99%

Erectile dysfunction in testicular cancer survivors: a meta-analysis of case-control studies

et al. 2020

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“…Hypogonadism also increases the risk of developing metabolic syndrome, including cardiovascular complications and diabetes, which appears to be greater after combination therapy (chemo-radiotherapy) ( 111 , 112 ). Research is currently underway to evaluate the impact of testosterone administration in long-term TC survivors, but results are still somewhat discordant ( 113 – 116 ).…”

Section: Stress-induced Immunosenescence In Testicular Cancer Survivomentioning

confidence: 99%

Immunosenescence in Testicular Cancer Survivors: Potential Implications of Cancer Therapies and Psychological Distress

et al. 2021

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Testicular cancer (TC) is the most frequent solid tumor diagnosed in young adult males. Although it is a curable tumor, it is frequently associated with considerable short-term and long-term morbidity. Both biological and psychological stress experienced during cancer therapy may be responsible for stimulating molecular processes that induce premature aging and deterioration of immune system (immunosenescence) in TC survivors, leading to an increased susceptibility to infections, cancer, and autoimmune diseases. Immunosenescence is a remodeling of immune cell populations with inversion of the CD4:CD8 ratio, accumulation of highly differentiated memory cells, shrinkage of telomeres, shift of T-cell response to Th2 type, and release of pro-inflammatory signals. TC survivors exposed to chemotherapy show features of immunological aging, including an increase in memory T-cells (CD4+ and CD8+) and high expression of the senescence biomarker p16INK4a in CD3+ lymphocytes. However, the plethora of factors involved in the premature aging of TC survivors make the situation more complex if we also take into account the psychological stress and hormonal changes experienced by patients, as well as the high-dose chemotherapy and hematopoietic stem cell transplantation that some individuals may be required to undergo. The relatively young age and the long life expectancy of TC patients bear witness to the importance of improving quality of life and of alleviating long-term side-effects of cancer treatments. Within this context, the present review takes an in-depth look at the molecular mechanisms of immunosenescence, describing experimental evidence of cancer survivor aging and highlighting the interconnected relationship between the many factors modulating the aging of the immune system of TC survivors.

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“…2 More than 95% of testicular tumors are diagnosed as testicular germ cell tumors (TGCTs). 3 Germ cell tumors (GCT) comprise of *98% of TCs. 4 Other GCTs include stromal tumors (2%), such as Leydig cell (*0.2%) and Sertoli cell tumors (*0.1).…”

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confidence: 99%

“…29 Kenney et al 29 reported that 20% of young adult male cancer patients experienced erectile dysfunction subsequent to treatment, and these findings were supported by several other studies revealing that more than half of all survivors presented with ejaculatory dysfunction following treatment. 3,30 These consequential reproductive outcomes, in relation to fatherhood, can have a detrimental effect on a patient's physical and psychological wellbeing, maintaining relationships, and quality of life. 31 Hence, discussion and counseling around sexuality, reproductive function, and fertility preservation are important before starting gonadotoxic treatment.…”

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confidence: 99%

Fatherhood Following Treatment for Testicular Cancer: A Systematic Review and Meta-Analyses

Gerstl

Bertoldo

Sullivan

et al. 2020

Journal of Adolescent and Young Adult Oncology

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Purpose: Testicular cancer (TC) is considered the most commonly diagnosed malignancy in males between 15 and 34 years of age. The objective of this study is to systematically review and meta-analyze studies on fatherhood following treatment for TC. Methods: We reviewed studies reporting on fatherhood following TC from Medline and Embase search engines by developing search strategies. Only studies including patients with TC and at least one reproductive variable were considered as part of the analysis. Estimate of heterogeneity was calculated using the I 2 statistic. Metaanalyses employing a fixed effects model were also applied as an additional measure of sensitivity. Results: A total of 27 studies were included which reported on fatherhood after treatment for TC. A meta-analysis of included studies with subgroup analysis was conducted. Subgroup analysis, for the combined studies, indicated an overall pooled pregnancy rate of 22% (95% confidence intervals [CI]: 0.21-0.23; I 2 = 98.1%) for couples who conceived after TC. Of those couples that became pregnant, 11% (95% CI: 0.07-0.16; I 2 = 8.5%) experienced a miscarriage. Fatherhood was experienced by 37% (95% CI: 0.35-0.39; I 2 = 98.1%) of males following treatment for TC. Conclusions: Male cancer patients should be offered discussions, information, and counseling regarding the impact that TC treatment can have on fertility. Furthermore, sperm banking must be recommended to all patients before starting treatment.

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Hypogonadism and Sexual Dysfunction in Testicular Tumor Survivors: A Systematic Review

Cited by 27 publications

References 59 publications

Erectile dysfunction in testicular cancer survivors: a meta-analysis of case-control studies

Erectile dysfunction in testicular cancer survivors: a meta-analysis of case-control studies

Immunosenescence in Testicular Cancer Survivors: Potential Implications of Cancer Therapies and Psychological Distress

Fatherhood Following Treatment for Testicular Cancer: A Systematic Review and Meta-Analyses

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