Hypogonadism is a potential manifestation of many chronic diseases including cancer, presumably related to their severity. Since novel anti-cancer treatments have significantly increased survival rates of affected patients, issue of hypogonadism becomes more significant, given the importance of issues like quality of life and potential for reproduction. The aim of our study was to analyze gonadal axis function in male patients with neuroendocrine tumors.
Subjects and methods
We retrospectively analyzed 43 male patients aged 57.7 ± 13.5 years (1576) with diagnosed neuroendocrine tumor and available hormonal data, prior to initiation of specific anti-cancer treatment. None of the patients had concomitant pituitary adenoma. All patients underwent standard oncological evaluation, with tumor staging and grading. Blood samples were taken for determination of testosterone, FSH (follicule-stimulating hormone) and LH (luteinizing hormone), as well as routine biochemical analyses. Basic antropometric parameters were measured. Statistical analysis was performed by SPSS software.
Minority of patients in our group were younger than 50 years of age (8, 18.6%). All, but 2 had metastatic disease, with unknown primary in 39.5% (17), pancreatic in 30.2% (13), lung in 20.9% (9), small intestinal in 7.0% (3), and pharyngeal tumor in 2.3% (1) of cases. Three patients had grade 1 tumor (7.0%), 14 grade 2 (32.6%), and 26 grade 3 (60.5%). Low testosterone level was diagnosed in 4 patients (9.3%). After exclusion of one patient with ectopic Cushings syndrome, malignant disease could be atributed as a cause in remaining cases (6.97%), hypogonadotropic in 2 cases, and hypergonadotropic in 1. Overall 6 patients had elevated LH levels (5.9 ± 3.4, 115), suggesting a certain degree of subclinical primary hypogonadism in 14.0% of our patients. There was no correlation between testosterone levels and any of biochemical and antropometric parameters (P > 0.05). There was no significant difference in testosterone levels between patients with different tumor grades (P = 0.579). Elevated FSH level was observed in 32.6% (14) patients, suggesting spermatogenesis failure. Only one patient younger than 50 had elevated FSH (15.9 ± 19.5, 0.5102.0), and none had elevated LH, while there was no significant difference in tumor grades between two age groups (P = 0.711). Afore mentioned differences in FSH, LH and testosterone did not affect survival in our group of patients (P > 0.05 for all).
Based on preliminary data, presence of neuroendocrine tumor doesnt seem to have a significant impact on gonadal function, at least in younger patients. Risk for spermatogenesis failure should be explored further).
22 May 2021 - 26 May 2021