Sexual Function in a Nationwide Cohort of 2,260 Survivors of Testicular Cancer after 17 Years of Followup

Mikkel Bandak; Jakob Lauritsen; Christoffer Johansen; Michael Kreiberg; Julie Wang Skøtt; Mads Agerbaek; Niels V Holm; Gedske Daugaard

doi:10.1016/j.juro.2018.04.077

Sexual Function in a Nationwide Cohort of 2,260 Survivors of Testicular Cancer after 17 Years of Followup

Mikkel Bandak, Jakob Lauritsen, Christoffer Johansen, Michael Kreiberg, Julie Wang Skøtt, Mads Agerbaek, Niels V Holm, Gedske Daugaard

Department of Clinical Medicine

8 Citations (Scopus)

Abstract

Purpose: Evidence on the long-term impact of testicular cancer treatment on sexual function is not clear. Our aim was to estimate the effect of testicular cancer treatment on the risk of sexual dysfunction in long-term survivors of testicular cancer. Materials and Methods: We performed a cross-sectional study of 2,260 long-term survivors of testicular cancer with a median followup of 17 years (IQR 12–24), including 1,098 who underwent orchiectomy alone (surveillance), 788 treated with bleomycin, etoposide and cisplatin alone or post-chemotherapy retroperitoneal surgery, 300 treated with abdominal radiotherapy and 74 who received more than 1 line of treatment. Sexual function was evaluated by the IIEF-15 (International Index of Erectile Function-15) questionnaire. Results were compared between treatment groups using logistic regression analysis with the results on each of the 5 IIEF-15 dimensions as the outcome and treatment as exposure using surveillance as the referent. Results: The risk of erectile dysfunction was increased in all treatment groups compared to surveillance, including bleomycin, etoposide and cisplatin alone (OR 1.5, 95% CI 1.0–2.1, p <0.05), bleomycin, etoposide and cisplatin with post-chemotherapy surgery (OR 2.1, 95% CI 1.4–3.4, p <0.005), radiotherapy (OR 1.7, 95% CI 1.1–2.5, p <0.05) and more than 1 line of treatment (OR 3.2, 95% CI 1.6–6.3, p <0.005). Orgasmic dysfunction was associated with radiotherapy, bleomycin, etoposide and cisplatin with post-chemotherapy surgery and more than 1 line of treatment. Conclusions: Treatment with bleomycin, etoposide and cisplatin, radiotherapy and more than 1 treatment line increased the risk of erectile dysfunction in long-term survivors of testicular cancer compared to surveillance. Patients should be informed about this as part of the information on treatment related late effects.

Original language	English
Journal	The Journal of Urology
Volume	200
Issue number	4
Pages (from-to)	794-800
ISSN	0022-5347
DOIs	https://doi.org/10.1016/j.juro.2018.04.077
Publication status	Published - Oct 2018

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10.1016/j.juro.2018.04.077

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@article{92c5a5e4cfe541328f9c1dc81ee4f9af,

title = "Sexual Function in a Nationwide Cohort of 2,260 Survivors of Testicular Cancer after 17 Years of Followup",

abstract = "Purpose: Evidence on the long-term impact of testicular cancer treatment on sexual function is not clear. Our aim was to estimate the effect of testicular cancer treatment on the risk of sexual dysfunction in long-term survivors of testicular cancer. Materials and Methods: We performed a cross-sectional study of 2,260 long-term survivors of testicular cancer with a median followup of 17 years (IQR 12–24), including 1,098 who underwent orchiectomy alone (surveillance), 788 treated with bleomycin, etoposide and cisplatin alone or post-chemotherapy retroperitoneal surgery, 300 treated with abdominal radiotherapy and 74 who received more than 1 line of treatment. Sexual function was evaluated by the IIEF-15 (International Index of Erectile Function-15) questionnaire. Results were compared between treatment groups using logistic regression analysis with the results on each of the 5 IIEF-15 dimensions as the outcome and treatment as exposure using surveillance as the referent. Results: The risk of erectile dysfunction was increased in all treatment groups compared to surveillance, including bleomycin, etoposide and cisplatin alone (OR 1.5, 95% CI 1.0–2.1, p <0.05), bleomycin, etoposide and cisplatin with post-chemotherapy surgery (OR 2.1, 95% CI 1.4–3.4, p <0.005), radiotherapy (OR 1.7, 95% CI 1.1–2.5, p <0.05) and more than 1 line of treatment (OR 3.2, 95% CI 1.6–6.3, p <0.005). Orgasmic dysfunction was associated with radiotherapy, bleomycin, etoposide and cisplatin with post-chemotherapy surgery and more than 1 line of treatment. Conclusions: Treatment with bleomycin, etoposide and cisplatin, radiotherapy and more than 1 treatment line increased the risk of erectile dysfunction in long-term survivors of testicular cancer compared to surveillance. Patients should be informed about this as part of the information on treatment related late effects.",

author = "Mikkel Bandak and Jakob Lauritsen and Christoffer Johansen and Michael Kreiberg and Sk{\o}tt, {Julie Wang} and Mads Agerbaek and Holm, {Niels V} and Gedske Daugaard",

year = "2018",

month = oct,

doi = "10.1016/j.juro.2018.04.077",

language = "English",

volume = "200",

pages = "794--800",

journal = "The Journal of Urology",

issn = "0022-5347",

publisher = "Elsevier",

number = "4",

}

TY - JOUR

T1 - Sexual Function in a Nationwide Cohort of 2,260 Survivors of Testicular Cancer after 17 Years of Followup

AU - Bandak, Mikkel

AU - Lauritsen, Jakob

AU - Johansen, Christoffer

AU - Kreiberg, Michael

AU - Skøtt, Julie Wang

AU - Agerbaek, Mads

AU - Holm, Niels V

AU - Daugaard, Gedske

PY - 2018/10

Y1 - 2018/10

N2 - Purpose: Evidence on the long-term impact of testicular cancer treatment on sexual function is not clear. Our aim was to estimate the effect of testicular cancer treatment on the risk of sexual dysfunction in long-term survivors of testicular cancer. Materials and Methods: We performed a cross-sectional study of 2,260 long-term survivors of testicular cancer with a median followup of 17 years (IQR 12–24), including 1,098 who underwent orchiectomy alone (surveillance), 788 treated with bleomycin, etoposide and cisplatin alone or post-chemotherapy retroperitoneal surgery, 300 treated with abdominal radiotherapy and 74 who received more than 1 line of treatment. Sexual function was evaluated by the IIEF-15 (International Index of Erectile Function-15) questionnaire. Results were compared between treatment groups using logistic regression analysis with the results on each of the 5 IIEF-15 dimensions as the outcome and treatment as exposure using surveillance as the referent. Results: The risk of erectile dysfunction was increased in all treatment groups compared to surveillance, including bleomycin, etoposide and cisplatin alone (OR 1.5, 95% CI 1.0–2.1, p <0.05), bleomycin, etoposide and cisplatin with post-chemotherapy surgery (OR 2.1, 95% CI 1.4–3.4, p <0.005), radiotherapy (OR 1.7, 95% CI 1.1–2.5, p <0.05) and more than 1 line of treatment (OR 3.2, 95% CI 1.6–6.3, p <0.005). Orgasmic dysfunction was associated with radiotherapy, bleomycin, etoposide and cisplatin with post-chemotherapy surgery and more than 1 line of treatment. Conclusions: Treatment with bleomycin, etoposide and cisplatin, radiotherapy and more than 1 treatment line increased the risk of erectile dysfunction in long-term survivors of testicular cancer compared to surveillance. Patients should be informed about this as part of the information on treatment related late effects.

AB - Purpose: Evidence on the long-term impact of testicular cancer treatment on sexual function is not clear. Our aim was to estimate the effect of testicular cancer treatment on the risk of sexual dysfunction in long-term survivors of testicular cancer. Materials and Methods: We performed a cross-sectional study of 2,260 long-term survivors of testicular cancer with a median followup of 17 years (IQR 12–24), including 1,098 who underwent orchiectomy alone (surveillance), 788 treated with bleomycin, etoposide and cisplatin alone or post-chemotherapy retroperitoneal surgery, 300 treated with abdominal radiotherapy and 74 who received more than 1 line of treatment. Sexual function was evaluated by the IIEF-15 (International Index of Erectile Function-15) questionnaire. Results were compared between treatment groups using logistic regression analysis with the results on each of the 5 IIEF-15 dimensions as the outcome and treatment as exposure using surveillance as the referent. Results: The risk of erectile dysfunction was increased in all treatment groups compared to surveillance, including bleomycin, etoposide and cisplatin alone (OR 1.5, 95% CI 1.0–2.1, p <0.05), bleomycin, etoposide and cisplatin with post-chemotherapy surgery (OR 2.1, 95% CI 1.4–3.4, p <0.005), radiotherapy (OR 1.7, 95% CI 1.1–2.5, p <0.05) and more than 1 line of treatment (OR 3.2, 95% CI 1.6–6.3, p <0.005). Orgasmic dysfunction was associated with radiotherapy, bleomycin, etoposide and cisplatin with post-chemotherapy surgery and more than 1 line of treatment. Conclusions: Treatment with bleomycin, etoposide and cisplatin, radiotherapy and more than 1 treatment line increased the risk of erectile dysfunction in long-term survivors of testicular cancer compared to surveillance. Patients should be informed about this as part of the information on treatment related late effects.

U2 - 10.1016/j.juro.2018.04.077

DO - 10.1016/j.juro.2018.04.077

M3 - Journal article

C2 - 29730199

SN - 0022-5347

VL - 200

SP - 794

EP - 800

JO - The Journal of Urology

JF - The Journal of Urology

IS - 4

ER -

Sexual Function in a Nationwide Cohort of 2,260 Survivors of Testicular Cancer after 17 Years of Followup

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