CARTfan
02-04-04, 07:16 PM
Fertility after testicular cancer treatments
Results of a large multicenter study
Eric Huyghe, M.D. 1 2, Tomohiro Matsuda, M.Sc. 1, Myriam Daudin, M.D. 1 3, Christine Chevreau, M.D. 4, Jean-Marc Bachaud, M.D. 4, Pierre Plante, M.D. 1 2, Louis Bujan, M.D. 1 3, Patrick Thonneau, M.D., M.Sc., Ph.D. 1 *
1Human Fertility Research Group, Paule de Viguier Hospital, Toulouse, France
2Urology Department, Rangueil Hospital, Toulouse, France
3Regional Semen Banking Unit, Centre Etude et de Conservation de Sperme (CECOS) Midi-Pyrénées, La Grave Hospital, Toulouse, France
4Claudius Regaud Cancer Institute, Toulouse, France
email: Patrick Thonneau (thonneau.p.@chu-toulouse.fr)
*Correspondence to Patrick Thonneau, Human Fertility Research Group, Paule de Viguier Hospital, 330 Avenue de Grande Bretagne, TSA 70034, 31059 Toulóuse Cedex 9, France
Fax. (011) 33 567771043
Funded by:
French National Institute of Health and Medical Research
Fondation pour la Recherche Medicale
CECOS Midi-Pyrénées
Keywords
testicular cancer • fertility • chemotherapy • radiotherapy
Abstract
BACKGROUND
Patients with testicular cancer have an excellent survival rate, and fertility is one of the main concerns of survivors. The authors investigated fertility status after treatment for testis cancer in long-term survivors.
METHODS
Four hundred fifty-one consecutive patients with testicular cancer (1979-1999) from health facilities in the French Midi-Pyrenees region were enrolled. Testis tumors were classified according to the Royal Marsden Hospital Classification. Fertility status was assessed by means of a mailed, standardized questionnaire focused on reproductive events that occurred before and after treatment. Of 451 patients with germ-cell tumors, information concerning fertility was obtained in 446 patients (98.9%). The follow-up was at least 3 years.
RESULTS
Before they were diagnosed with testicular cancer, 91.2% of patients who had tried to get their partners pregnant had succeeded, compared with 67.1% of patients after treatment. Radiotherapy had a much more deleterious effect on fertility compared with chemotherapy alone. Furthermore, cumulative conception rates (log-rank test) for patients who received radiotherapy were significantly lower compared with the rates for patients who received chemotherapy.
CONCLUSIONS
The outcome of this study, which included the largest series reported to date, showed that fertility in patients with testicular cancer decreased by 30% after treatments and that radiotherapy seemed to have the most deleterious effect on fertility. Cancer 2004;100:732-7. © 2004 American Cancer Society.
Results of a large multicenter study
Eric Huyghe, M.D. 1 2, Tomohiro Matsuda, M.Sc. 1, Myriam Daudin, M.D. 1 3, Christine Chevreau, M.D. 4, Jean-Marc Bachaud, M.D. 4, Pierre Plante, M.D. 1 2, Louis Bujan, M.D. 1 3, Patrick Thonneau, M.D., M.Sc., Ph.D. 1 *
1Human Fertility Research Group, Paule de Viguier Hospital, Toulouse, France
2Urology Department, Rangueil Hospital, Toulouse, France
3Regional Semen Banking Unit, Centre Etude et de Conservation de Sperme (CECOS) Midi-Pyrénées, La Grave Hospital, Toulouse, France
4Claudius Regaud Cancer Institute, Toulouse, France
email: Patrick Thonneau (thonneau.p.@chu-toulouse.fr)
*Correspondence to Patrick Thonneau, Human Fertility Research Group, Paule de Viguier Hospital, 330 Avenue de Grande Bretagne, TSA 70034, 31059 Toulóuse Cedex 9, France
Fax. (011) 33 567771043
Funded by:
French National Institute of Health and Medical Research
Fondation pour la Recherche Medicale
CECOS Midi-Pyrénées
Keywords
testicular cancer • fertility • chemotherapy • radiotherapy
Abstract
BACKGROUND
Patients with testicular cancer have an excellent survival rate, and fertility is one of the main concerns of survivors. The authors investigated fertility status after treatment for testis cancer in long-term survivors.
METHODS
Four hundred fifty-one consecutive patients with testicular cancer (1979-1999) from health facilities in the French Midi-Pyrenees region were enrolled. Testis tumors were classified according to the Royal Marsden Hospital Classification. Fertility status was assessed by means of a mailed, standardized questionnaire focused on reproductive events that occurred before and after treatment. Of 451 patients with germ-cell tumors, information concerning fertility was obtained in 446 patients (98.9%). The follow-up was at least 3 years.
RESULTS
Before they were diagnosed with testicular cancer, 91.2% of patients who had tried to get their partners pregnant had succeeded, compared with 67.1% of patients after treatment. Radiotherapy had a much more deleterious effect on fertility compared with chemotherapy alone. Furthermore, cumulative conception rates (log-rank test) for patients who received radiotherapy were significantly lower compared with the rates for patients who received chemotherapy.
CONCLUSIONS
The outcome of this study, which included the largest series reported to date, showed that fertility in patients with testicular cancer decreased by 30% after treatments and that radiotherapy seemed to have the most deleterious effect on fertility. Cancer 2004;100:732-7. © 2004 American Cancer Society.