Acute primary testicular failure due to radiotherapy increases risk of severe postoperative adverse events in rectal cancer patients

The aim of this study is to analyze postoperative adverse events (AE) in relation to acute primary testicular failure after radiotherapy (RT) for rectal cancer. This relation was assessed in 104 men, included in a previous prospective cohort study of men treated with surgical resection of the rectum...

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Bibliographic Details
Published in:European journal of surgical oncology 2020-01, Vol.46 (1), p.98-104
Main Authors: Tapper, John, Arver, Stefan, Holm, Torbjörn, Bottai, Matteo, Machado, Mikael, Jasuja, Ravi, Martling, Anna, Buchli, Christian
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Biomarkers - blood
Combined Modality Therapy
Humans
Leydig cell function
Male
Middle Aged
Neoplasm Staging
Postoperative Complications - epidemiology
Preoperative radiotherapy
Prospective Studies
Radiotherapy Dosage
Rectal cancer
Rectal Neoplasms - pathology
Rectal Neoplasms - radiotherapy
Rectal Neoplasms - surgery
Risk Factors
Testicular dose
Testis - radiation effects
Testosterone
Testosterone - blood
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Summary:The aim of this study is to analyze postoperative adverse events (AE) in relation to acute primary testicular failure after radiotherapy (RT) for rectal cancer. This relation was assessed in 104 men, included in a previous prospective cohort study of men treated with surgical resection of the rectum for rectal cancer stage I-III. Postoperative AE were graded according to Clavien-Dindo (2004). Grade 3 or more was set as cut-off for severe postoperative AE. The impact of primary testicular failure on postoperative AE was related to the cumulative mean testicular dose (TD) and the change in Testosterone (T) and Luteinizing hormone (LH) sampled at baseline and after RT. Twenty-six study participants (25%) had severe postoperative AE. Baseline characteristics and endocrine testicular function did not differ significantly between groups with (AE+) and without severe postoperative AE (AE-). After RT, the LH/T-ratio was higher in AE+, 0.603 (0.2–2.5) vs 0.452 (0.127–5.926) (p = 0.035). The longitudinal regression analysis showed that preoperative change in T (OR 0.844, 95% CI 0.720–0.990, p = 0.034), LH/T-ratio (OR 2.020, 95% CI 1.010–4.039, p = 0.047) and low T (
ISSN:0748-7983
1532-2157
DOI:10.1016/j.ejso.2019.07.023