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568 FERTILITY AFTER ADJUVANT SINGLE-AGENT CARBOPLATIN THERAPY FOR CLINICAL STAGE I SEMINOMA

2010; Lippincott Williams & Wilkins; Volume: 183; Issue: 4S Linguagem: Inglês

10.1016/j.juro.2010.02.814

1527-3792

Nicolai Leonhartsberger, Andreas Fritzer, Brigitte Stoehr, Florian Zangerl, Hannes Steiner,

Sperm and Testicular Function

You have accessJournal of UrologyPenis/Testis/Urethra: Benign & Malignant Disease I1 Apr 2010568 FERTILITY AFTER ADJUVANT SINGLE-AGENT CARBOPLATIN THERAPY FOR CLINICAL STAGE I SEMINOMA Nicolai Leonhartsberger, Andreas Fritzer, Brigitte Stoehr, Florian Zangerl, and Hannes Steiner Nicolai LeonhartsbergerNicolai Leonhartsberger More articles by this author , Andreas FritzerAndreas Fritzer More articles by this author , Brigitte StoehrBrigitte Stoehr More articles by this author , Florian ZangerlFlorian Zangerl More articles by this author , and Hannes SteinerHannes Steiner More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.814AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Radiotherapy has been considered as standard adjuvant treatment for clinical Stage I seminoma for long time. The introduction of cisplatin-based chemotherapy has improved patient recovery dramatically. Although it is well known that carboplatin is a drug that binds directly to DNA, which is the presumptive method for killing cells, the mechanism of action of carboplatin on spermatozoa is unclear. Long-term toxicity becomes an important issue in this young age group of patients, and fertility especially has long-lasting consequences for their sexuality and quality of life. We analyzed the long-term damage to gonadal function and evaluated fertility of patients with clinical stage I seminoma after high-dose chemotherapy. METHODS Thirty patients patients with clinical stage I seminoma were treated with two postoperative adjuvant courses of carboplatin (400mg/m2 body surface area scheduled for days 1 and 22) in our hospital. Mean age was 38,4 years. All patients had histologically confirmed seminoma with resection margins free of tumor. Adjuvant chemotherapy was started approximately 14 days after operation. All patients underwent semen analysis more than 12 months after chemotherapy with at least 3 days of sexual inactivity. Sperm evaluation from antegrade ejaculation included sperm density, motility, volume and percentage of vital and abnormal spermatozoa. Data on gonadal function (serum hormone levels) were obtained, too. RESULTS Spermatogenesis was restored after cessation of chemotherapy in 16 of 30 patients (53.33%). The follow-up period was similar in both groups. The mean sperm concentration in non-oligospermic patients was 45,25 million./mL., in oligospermic patients 5,75 million/mL. Motility was reduced in both groups, nonoligospermic patients showed 43,9% compared to 16,0% in the oligospermic group. No significant disorder in vitalogy and sperm morhology was observed. Testosterone, FSH and LH levels were within normal range. CONCLUSIONS Fertility status after chemotherapy is difficult to predict, spermatogenesis recovers in some patients. Even before orchiectomy spermatogenesis is already impaired in men with testicular cancer. Therefore patients should also be informed about the risk of infertility and crypreservation of semen before treatment. Patients after therapy Sperm count (million/mL) mean Progressive motility (%) mean Morphology (%) mean Vitality (%) mean Oligospermic 14 5.75 16.0 41.5 75.2 Normospermic 16 45.25 43.9 51.6 77.3 Total 30 28.6 33.1 48.3 76.5 Innsbruck, Austria© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e222-e223 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nicolai Leonhartsberger More articles by this author Andreas Fritzer More articles by this author Brigitte Stoehr More articles by this author Florian Zangerl More articles by this author Hannes Steiner More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...