Table 2.
Treatment modalities and fertility‐related variables for survivors of testicular cancer (TC)
| Authors Year of study report | Survivors of TC included (N) | Median follow‐up (years) (range) | Treatment modality | Patients (N) | Major variables compared | Main results |
|---|---|---|---|---|---|---|
|
Arai et al.45
1997 |
85 | 7.7 (1.0‐21.8) |
SV CT+RPLND CT‐RPLND RT |
9 19 15 42 |
Post‐treatment sexual function, marital status, fertility distress | Highest rate of infertility distress was observed in patients with CT |
|
Spermon et al.46
2003 |
226 | 7.4 (1.6‐18.7) |
SV RT PRPLND PRPLND+CT CT CT+SRPLND |
20 36 44 42 44 40 |
Patients who attempted and fulfilled fatherhood (%) | 48% (38) of 88 couples conceived within 1 year; treatment modality did not significantly affect conception rates |
|
Nord et al.42
2003 |
1183 | 11.0 (N/A) |
SV RT Cisplatin (<850 mg) Cisplatin (>850 mg) Healthy controls |
52 515 373 96 200 |
Serum sexual hormones, % of men with hypogonadism (defined as serum T<8 nmol/L, LH>12 IU/L, or using T supplementation) | Age‐adjusted odds ratio of hypogonadism was 3.8 (95% CI: 2.0‐7.3) in patients with TC and increased with treatment intensity |
|
Huyghe et al.4
2004 |
451 | 8.0 (3.0‐26.5) |
SV or RPLND CT RT Others |
21 143 171 116 |
Fertility status, including reproductive events | Cumulative conception rates in patients with CT were higher than those with RT |
|
Huddart et al.44
2005 |
680 | 10.2 (0.0‐20.3) |
SV CT CT+RT RT |
169 272 81 158 |
Patients who attempted and succeeded in conception (%), level of gonadal hormones | In CT group, 31% (83) tried to conceive and 75% (62) succeeded with/without infertility treatment; in CT/RT group, 30% (24) tried and 83% (20) succeeded |
|
Brydøy et al.43
2005 |
1433 | 10.6 (4.0‐21.0) |
SV RPLND RT Cisplatin (<850 mg) Cisplatin (>850 mg) |
119 153 610 447 104 |
Patients who attempted and succeeded in conception (%), years from beginning treatment to first‐born child | Success rates of patients who attempted to conceive were 81%, 77%, 65%, 62%, and 38% with each modality, respectively (P<.001) |
|
Gandini et al.47
2006 |
166 | 2.0 (N/A) |
CT RT |
71 95 |
Sperm parameters at 3, 6, 9, 12, and 24 months after treatment | At 2 years after treatment, 3% of CT group and 6% of RT group remained with azoospermia |
|
Brydøy et al.48
2010 |
316 | 12.0 (5.0‐20.0) |
CT (two cycles) CT (three cycles) CT (four cycles) |
20 79 217 |
Sperm count, level of gonadal hormones, % of patients who achieved fatherhood, % of patients with normal ejaculation | Paternity rates for two, three, and four cycles were 100%, 83%, and 76%, respectively (P=.022) |
|
Ping et al.49
2014 |
125 | 10.2 (1.0‐15.0) |
SV RPLND CT RT CT+RT |
36 11 35 28 7 |
Patients who attempted and succeeded in conception (%) | CT, RT, and RPLND were the most highly correlated with a lack of conception |
CI, confidence interval; CT, chemotherapy; LH, luteinizing hormone; N/A, not available; PRPLND, primary RPLND; RPLND, retroperitoneal lymph node dissection; RT, radiotherapy; SRPLND, secondary RPLND; SV, surveillance; T, testosterone.