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Tverye A, Nangia A, Fantus RJ. Testicular Cancer Survivorship and Fertility Preservation. Urol Clin North Am 2024; 51:429-438. [PMID: 38925745 DOI: 10.1016/j.ucl.2024.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
Testicular cancer disproportionally affects men of reproductive age making fertility an important aspect of testicular cancer survivorship. Men with testicular cancer have more semen parameter abnormalities and a higher incidence of infertility compared to the general population. All treatment options for testicular cancer negatively affect fertility with recovery rates varying by treatment. For these reasons, clinicians should offer sperm cryopreservation, ideally before orchiectomy to maximize the possibility of biologic paternity, if desired. Several innovations have positively impacted this space including direct-to-consumer cryopreservation and bench research demonstrating the feasibility of reintroducing testicular cells post-therapy.
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Affiliation(s)
- Aaron Tverye
- Department of Urology, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA
| | - Ajay Nangia
- Department of Urology, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA
| | - Richard J Fantus
- Department of Urology, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA.
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2
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Gulino G, Distante A, Akhundov A, Bassi PF. Male infertility and urological tumors: Pathogenesis and therapeutical implications. Urologia 2023; 90:622-630. [PMID: 37491831 PMCID: PMC10623618 DOI: 10.1177/03915603221146147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 02/22/2022] [Indexed: 07/27/2023]
Abstract
Most genitourinary tract cancers have a negative impact on male fertility. Although testicular cancers have the worst impact, other tumors such as prostate, bladder, and penis are diagnosed early and treated in relatively younger patients in which couple fertility can be an important concern. The purpose of this review is to highlight both the pathogenetic mechanisms of damage to male fertility in the context of the main urological cancers and the methods of preserving male fertility in an oncological setting, in light of the most recent scientific evidence. A systematic review of available literature was carried out on the main scientific search engines, such as PubMed, Clinicaltrials.Gov, and Google scholar. Three hundred twenty-five relevant articles on this subject were identified, 98 of which were selected being the most relevant to the purpose of this review. There is a strong evidence in literature that all of the genitourinary oncological therapies have a deep negative impact on male fertility: orchiectomy, partial orchiectomy, retroperitoneal lymphadenectomy (RPLND), radical cystectomy, prostatectomy, penectomy, as well as radiotherapy, chemotherapy, and hormonal androgen suppression. Preservation of fertility is possible and includes cryopreservation, hormonal manipulation with GnRH analogs before chemotherapy, androgen replacement. Germ cell auto transplantation is an intriguing strategy with future perspectives. Careful evaluation of male fertility must be a key point before treating genitourinary tumors, taking into account patients' age and couples' perspectives. Informed consent should provide adequate information to the patient about the current state of his fertility and about the balance between risks and benefits in oncological terms. Standard approaches to genitourinary tumors should include a multidisciplinary team with urologists, oncologists, radiotherapists, psycho-sexologists, andrologists, gynecologists, and reproductive endocrinologists.
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Affiliation(s)
- G Gulino
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - A Distante
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - A Akhundov
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - PF Bassi
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
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3
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Cirigliano L, Falcone M, Gül M, Preto M, Ceruti C, Plamadeala N, Peretti F, Ferro I, Scavone M, Gontero P. Onco-TESE (Testicular Sperm Extraction): Insights from a Tertiary Center and Comprehensive Literature Analysis. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1226. [PMID: 37512038 PMCID: PMC10386487 DOI: 10.3390/medicina59071226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/20/2023] [Accepted: 06/28/2023] [Indexed: 07/30/2023]
Abstract
Background and Objectives: The peak of incidence of testicular cancer (TC) occurs among individuals in their reproductive age, emphasizing the importance of fertility preservation as an integral aspect of disease management. Sperm cryopreservation performed before orchiectomy is ineffective in azoospermic men, necessitating alternative approaches such as microdissection testicular sperm extraction (mTESE) at the time of orchiectomy (onco-mTESE) to obtain viable sperm. This study presents the findings from our institution's experience with onco-mTESE and critically discusses our results in light of the existing body of literature. Materials and Methods: This is a tertiary center retrospective analysis of onco-mTESE procedures performed at a single center between December 2011 and July 2022. The included patients were post-puberal men with testicular tumors requiring orchiectomy, along with concomitant severe oligozoospermia or azoospermia. Bilateral mTESE was performed in all cases. Surgical outcomes, sperm retrieval rates, the usage of preserved viable sperm, assistive reproductive techniques' results, and post-operative serum testosterone were recorded. Results: A total of nine patients were included, with a median age of 34 (IQR 29-36) years. All patients had germ cell tumors (GCTs), with seminomatous and non-seminomatous GCTs accounting for 44.4% (n = 4) and 55.6% (n = 5) of patients, respectively. Sperm retrieval occurred in three (33%) patients: one patient in the ipsilateral testis, one in the contralateral testis, and one in both testes. No complications were reported during the procedure, and no post-operative hypogonadism was observed. Among the three patients with successful sperm retrieval, an intracytoplasmic sperm injection (ICSI) was performed in two patients, resulting in two pregnancies, leading to one healthy live birth and one miscarriage. Conclusions: In the context of TC, it is essential to conduct a thorough evaluation of testicular function, including a semen analysis and cryopreservation. Onco-mTESE has proven its safety in preserving fertility in azoospermic cases while ensuring the efficacy of oncological treatment.
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Affiliation(s)
- Lorenzo Cirigliano
- Urology Clinic-A.O.U. "Città della Salute e della Scienza"-Molinette Hospital, University of Turin, 10100 Turin, Italy
| | - Marco Falcone
- Urology Clinic-A.O.U. "Città della Salute e della Scienza"-Molinette Hospital, University of Turin, 10100 Turin, Italy
- Neurourology Clinic-A.O.U. "Città della Salute e della Scienza"-Unità Spinale Unipolare, 10100 Turin, Italy
| | - Murat Gül
- Urology Clinic-A.O.U. "Città della Salute e della Scienza"-Molinette Hospital, University of Turin, 10100 Turin, Italy
- Department of Urology, School of Medicine, Selcuk University, Konya 42005, Turkey
| | - Mirko Preto
- Urology Clinic-A.O.U. "Città della Salute e della Scienza"-Molinette Hospital, University of Turin, 10100 Turin, Italy
| | - Carlo Ceruti
- Urology Clinic-A.O.U. "Città della Salute e della Scienza"-Molinette Hospital, University of Turin, 10100 Turin, Italy
| | - Natalia Plamadeala
- Urology Clinic-A.O.U. "Città della Salute e della Scienza"-Molinette Hospital, University of Turin, 10100 Turin, Italy
| | - Federica Peretti
- Urology Clinic-A.O.U. "Città della Salute e della Scienza"-Molinette Hospital, University of Turin, 10100 Turin, Italy
| | - Ilaria Ferro
- Urology Clinic-A.O.U. "Città della Salute e della Scienza"-Molinette Hospital, University of Turin, 10100 Turin, Italy
| | - Martina Scavone
- Urology Clinic-A.O.U. "Città della Salute e della Scienza"-Molinette Hospital, University of Turin, 10100 Turin, Italy
| | - Paolo Gontero
- Urology Clinic-A.O.U. "Città della Salute e della Scienza"-Molinette Hospital, University of Turin, 10100 Turin, Italy
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Chua SC, Yovich SJ, Hinchliffe PM, Yovich JL. Male Clinical Parameters (Age, Stature, Weight, Body Mass Index, Smoking History, Alcohol Consumption) Bear Minimal Relationship to the Level of Sperm DNA Fragmentation. J Pers Med 2023; 13:jpm13050759. [PMID: 37240929 DOI: 10.3390/jpm13050759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 04/21/2023] [Accepted: 04/26/2023] [Indexed: 05/28/2023] Open
Abstract
This retrospective cohort study reports on 1291 males who were the partners of women presenting with infertility requiring assisted reproduction and who had sperm DNA fragmentation (SDF) levels measured by the Halosperm test. These men provided clinical and biometric details which included their age, stature, weight, and body mass index (BMI). Of these men, 562 (43.5%) provided detailed historical records of their smoking and alcohol histories. The aim of this study was to determine whether any clinical and biometric parameters, or main lifestyle factors, had any influence on SDF. We found that the only clinical parameter with a direct correlation was that of advancing age (r = 0.064, p = 0.02), but none of the biometric parameters of stature, weight, or BMI showed any significant correlation. In respect to lifestyle, there were significant correlations with smoking history, but not in the way we expected. Our data showed significantly elevated SDF levels among non-smokers (p = 0.03) compared with smokers. We also found that, among the non-smokers, ex-smokers had higher SDF levels (p = 0.03). With respect to alcohol, consumers did not show any significant differences in SDF levels. These lifestyle findings did not show any significant relevance with respect to an SDF level of <15% or ≥15%. Furthermore, logistic regression analysis excluded age as a confounder in these lifestyle findings. It is therefore concluded that, apart from age, both clinical and lifestyle aspects have minimal relevance to SDF.
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Affiliation(s)
- Shiao Chuan Chua
- PIVET Medical Centre, Perth, WA 6007, Australia
- Hospital Shah Alam, Shah Alam 40000, Selangor, Malaysia
| | | | | | - John Lui Yovich
- PIVET Medical Centre, Perth, WA 6007, Australia
- Faculty of Health Sciences, School of Medicine, Curtin University, Perth, WA 6102, Australia
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Shrem NS, Wood L, Hamilton RJ, Kuhathaas K, Czaykowski P, Roberts M, Matthew A, Izard JP, Chung P, Nappi L, Jones J, Soulières D, Aprikian A, Power N, Canil C. Testicular cancer survivorship: Long-term toxicity and management. Can Urol Assoc J 2022; 16:257-272. [PMID: 35905486 PMCID: PMC9343164 DOI: 10.5489/cuaj.8009] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Affiliation(s)
- Noa Shani Shrem
- Division of Medical Oncology, Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Lori Wood
- Division of Medical Oncology, Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, NS, Canada
| | - Robert J. Hamilton
- Division of Urology, Department of Surgical Oncology, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Kopika Kuhathaas
- Division of Urology, Department of Surgical Oncology, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Piotr Czaykowski
- Department of Medical Oncology and Hematology, CancerCare Manitoba, University of Manitoba, Winnipeg, MB, Canada
| | - Matthew Roberts
- Division of Urology, Department of Surgery, University of Ottawa, Ottawa, ON, Canada
| | - Andrew Matthew
- Department of Surgical Oncology, Princess Margaret Cancer Centre, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Jason P. Izard
- Departments of Urology and Oncology, Queen’s University, Kingston, ON, Canada
| | - Peter Chung
- Department of Radiation Oncology, Radiation Medicine Program, Princess Margaret Hospital, University of Health Network, University of Toronto, Toronto, ON, Canada
| | - Lucia Nappi
- Division of Medical Oncology, British Columbia Cancer - Vancouver Cancer Centre, University of British Columbia, Vancouver, BC, Canada
| | - Jennifer Jones
- Department of Supportive Care, Princess Margaret Cancer Centre, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Denis Soulières
- Division of Medical Oncology/Hematology, Le Centre Hospitalier de l’Université de Montréal, Montreal, QC, Canada
| | - Armen Aprikian
- Division of Urology, Department of Surgery, McGill University Health Centre, Montreal, QC, Canada
| | - Nicholas Power
- Division of Urology, Department of Surgery, Western University, London, ON, Canada
| | - Christina Canil
- Division of Medical Oncology, Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
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6
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Malone ER, Lewin J, Li X, Zhang WJ, Lau S, Jarvi K, Hamilton RJ, Hansen AR, Chen EX, Bedard PL. Semen and serum platinum levels in cisplatin-treated survivors of germ cell cancer. Cancer Med 2021; 11:728-734. [PMID: 34918879 PMCID: PMC8817086 DOI: 10.1002/cam4.4480] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 10/29/2021] [Accepted: 10/30/2021] [Indexed: 12/05/2022] Open
Abstract
Background Testicular cancer survivors often have impaired gonadal function possibly related to chemotherapy. Platinum is a heavy metal that can be detected at low levels in serum many years after treatment, it is not known whether platinum also persists in semen and if platinum persistence in semen is associated with impaired fertility. Methods Adult cisplatin‐treated testicular cancer survivors were enrolled. High‐Performance Liquid Chromatography‐tandem mass spectrometry was used to measure semen and serum platinum levels. Semen quality and DNA Fragmentation Index (DFI) were assessed. Results From 11/2017 to 12/2019, 38 patients (median age 32 years; range: 19–52) were enrolled. Median cumulative cisplatin dose was 301 mg/m2 (range: 274–404). Platinum levels were higher in semen than in blood (p = 0.03). Semen platinum levels were not significantly associated with time from last cisplatin dosing (r = −0.34; p = 0.09) nor cumulative dose (r = −0.10, p = 0.63). Sperm concentration was correlated with time from last cisplatin dosing (r = 0.58, p < 0.001) but not with semen platinum level (r = −0.15, p = 0.46). DFI was not significantly associated with time from last cisplatin dosing (r = 0.55, p = 0.08) or semen platinum level (r = −0.32, p = 0.33). In four patients with serial semen samples, platinum level decreased and sperm concentration and motility increased over time. Conclusions Platinum is detected in semen of testicular cancer survivors at higher levels than matched blood samples. These preliminary findings may have important implications for the reproductive health of survivors of advanced testicular cancer, further study is needed to assess the relationship between platinum persistence in semen and recovery of fertility postchemotherapy.
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Affiliation(s)
- Eoghan R Malone
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jeremy Lewin
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Xuan Li
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Wen-Jiang Zhang
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Susan Lau
- Murray Koffler Urologic Wellness Centre, Mount Sinai Hospital, Joseph and Wolff Lebovic Health Complex, Toronto, Ontario, Canada
| | - Keith Jarvi
- Division of Urology, University of Toronto, Toronto, Ontario, Canada.,Murray Koffler Urologic Wellness Centre, Mount Sinai Hospital, Joseph and Wolff Lebovic Health Complex, Toronto, Ontario, Canada
| | - Robert J Hamilton
- Division of Urology, University of Toronto, Toronto, Ontario, Canada
| | - Aaron R Hansen
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Eric X Chen
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Philippe L Bedard
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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7
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Farkouh A, Finelli R, Agarwal A. Beyond conventional sperm parameters: the role of sperm DNA fragmentation in male infertility. Minerva Endocrinol (Torino) 2021; 47:23-37. [PMID: 34881857 DOI: 10.23736/s2724-6507.21.03623-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Infertility is a condition that widely affects the couples all over the world. In this regard, sperm DNA fragmentation can lead to harmful reproductive consequences, including male infertility and poor outcomes after assisted reproductive techniques. The investigation of SDF in male infertility diagnostics has constantly increased over time, becoming more common in clinical practice with the recent publication of several guidelines regarding its testing. This narrative review aims to provide a comprehensive overview of the pathogenesis and causes of sperm DNA fragmentation, as well as the assays which are more commonly performed for testing. Moreover, we discussed the most recently published evidence regarding the use of SDF testing in clinical practice, highlighting the implications of high sperm DNA fragmentation rate on human reproduction, and the therapeutic approaches for the clinical management of infertile patients. Our review confirms a significant harmful impact of sperm DNA fragmentation on reproduction, and points out several interventions which can be applied in clinics to reduce sperm DNA fragmentation and improve reproductive outcomes. Sperm DNA fragmentation has been shown to adversely impact male fertility potential. As high sperm DNA fragmentation levels have been associated with poor reproductive outcomes, its testing may significantly help clinicians in defining the best therapeutic strategy for infertile patients.
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Affiliation(s)
- Ala'a Farkouh
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Renata Finelli
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA -
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8
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Montagnoli C, Ruggeri S, Cinelli G, Tozzi AE, Bovo C, Bortolus R, Zanconato G. Anything New about Paternal Contribution to Reproductive Outcomes? A Review of the Evidence. World J Mens Health 2021; 39:626-644. [PMID: 33474842 PMCID: PMC8443996 DOI: 10.5534/wjmh.200147] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 10/13/2020] [Accepted: 11/08/2020] [Indexed: 11/15/2022] Open
Abstract
Paternal health and behavioral lifestyles affect reproductive and neonatal outcomes and yet the magnitude of these effects remain underestimated. Even though these impacts have been formally recognized as a central aspect of reproductive health, health care services in Europe often neglect the involvement of fathers in their reproductive programs. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for systematic reviews, a literature search was carried out to assess the possible impact of paternal health on reproductive outcomes. The comprehensive strategy included cohort studies and meta-analysis available on PubMed, Web of Science, CINAHL, and Google scholar. Cross-referencing of bibliographies of the selected papers ensured wider study capture. Paternal factors were grouped into two categories respectively identified with the terms "Biological Paternal Factors" and "Lifestyle Paternal Factors". Advanced age may impair male fertility and affect early pregnancy stages. Increased body mass index, smoking, alcohol and recreational drugs, all alter seminal fluid parameters. Hazardous alcohol use correlates with low birthweight in pregnancy and harmful behavioral lifestyles have been linked to congenital heart defects, metabolic and neurodevelopmental disorders in the offspring. Measures targeting paternal health and lifestyle within the first 1,000 days' timeframe need to be implemented in couples undergoing reproductive decisions. Health professionals, as well as future fathers, must be aware of the benefits for the offspring associated with correct paternal behaviors. More research is needed to build guidelines and to implement specific programs aiming at reproductive health promotion.
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Affiliation(s)
- Caterina Montagnoli
- Department of Medical Direction, Verona University Hospital, Verona, Italy.,Department of Midwifery, Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Geneva, Switzerland
| | | | - Giulia Cinelli
- Predictive and Preventive Medicine Research Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Alberto E Tozzi
- Predictive and Preventive Medicine Research Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | - Chiara Bovo
- Department of Medical Direction, Verona University Hospital, Verona, Italy
| | - Renata Bortolus
- Directorate General for Preventive Health - Office 9, Ministry of Health, Rome, Italy
| | - Giovanni Zanconato
- Department of Surgery, Odontostomatology and Maternal and Child Health, University of Verona, Verona, Italy
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9
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Moura GAD, Monteiro PB. Cytotoxic Activity of Antineoplastic Agents on Fertility: A Systematic Review. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2020; 42:759-768. [PMID: 33254272 PMCID: PMC10309244 DOI: 10.1055/s-0040-1713911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE To analyze the long-term effects of antineoplastic treatments on patient fertility. SELECTION OF STUDIES The studies were selected through the New PubMed, Scielo and Lilacs databases along with references used for the creation of the present work. For the selection of studies, articles published between the periods from January 1, 2015 to April 6, 2020 in the English, Portuguese and Spanish languages were used. As inclusion criteria: cohort studies and studies conducted in vitro. As exclusion criteria: review articles, reported cases, studies that do not address thematic reproduction, studies that do not address the cancer theme, articles that used animals, articles that address the preservation of fertility and articles in duplicate in the bases. DATA COLLECTION The collected data included: age of the patient at the beginning of treatment, type of neoplasm, type of antineoplastic treatment, chemotherapy used, radiotherapy dosage, radiotherapy site, effect of antineoplastic agents on fertility and number of patients in the study. DATA SYNTHESIS Thirty studies were evaluated, antineoplastic chemotherapy agents and radiotherapy modulate serum hormone levels, reduces germ cell quantities and correlated with an increase in sterility rates. The effects mentioned occur in patients in the prepubertal and postpubertal age. CONCLUSION Antineoplastic treatments have cytotoxic effects on the germ cells leading to hormonal modulation, and pubertal status does not interfere with the cytotoxic action of therapies.
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Gerstl B, Bertoldo MJ, Sullivan E, Volckmar X, Kerr A, Wand H, Ives A, Albalawi O, Anazodo A. Fatherhood Following Treatment for Testicular Cancer: A Systematic Review and Meta-Analyses. J Adolesc Young Adult Oncol 2020; 9:341-353. [DOI: 10.1089/jayao.2019.0164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Brigitte Gerstl
- Department of Biostatistics, The Kirby Institute, University of New South Wales, Sydney, Australia
- Kids Cancer Center, Sydney Children's Hospital, Sydney, Australia
| | - Michael J. Bertoldo
- School of Women's and Children's Health, University of New South Wales, Sydney, Australia
- School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - Elizabeth Sullivan
- Faculty Health and Medicine, The University of Newcastle, Newcastle, Australia
| | - Xanthie Volckmar
- Department of Biostatistics, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Aidan Kerr
- Department of Biostatistics, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Handan Wand
- Department of Biostatistics, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Angela Ives
- Cancer and Palliative Care Research and Evaluation Unit, University of Western Australia, Crawley, Australia
| | - Olayan Albalawi
- Department of Biostatistics, The Kirby Institute, University of New South Wales, Sydney, Australia
- Department of Statistics, Science College, Tabuk University, Tabuk, Saudi Arabia
| | - Antoinette Anazodo
- Kids Cancer Center, Sydney Children's Hospital, Sydney, Australia
- School of Women's and Children's Health, University of New South Wales, Sydney, Australia
- Nelune Comprehensive Cancer Center, Prince of Wales Hospital, Sydney, Australia
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11
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Tesarik J. Acquired Sperm DNA Modifications: Causes, Consequences, and Potential Solutions. EUROPEAN MEDICAL JOURNAL 2019. [DOI: 10.33590/emj/10312990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
DNA of human spermatozoa can be subject to various kinds of modifications acquired throughout life. Put simply, two basic types of acquired sperm DNA modifications can be distinguished: genetic and epigenetic. Genetic modifications cause alterations of the DNA sequence and mainly result from the formation of breakpoints leading to sperm DNA fragmentation. Epigenetic modifications include a vast spectrum of events that influence the expression of different genes without altering their DNA sequence. Both the genetic and the epigenetic modifications of sperm DNA can negatively influence embryonic development, cause miscarriages, and be the origin of different health problems for the offspring. As to sperm DNA fragmentation, reliable diagnostic methods are currently available. On the other hand, the detection of potentially harmful epigenetic modifications in spermatozoa is a much more complicated issue. Different treatment options can be chosen to solve problems associated with sperm DNA fragmentation. Some are relatively simple and noninvasive, based on oral treatments with antioxidants and other agents, depending on the underlying cause. In other cases, the recourse to different micromanipulation-assisted in vitro fertilisation techniques is necessary to select spermatozoa with minimal DNA damage to be injected into oocytes. The treatment of cases with epigenetic DNA modifications is still under investigation. Preliminary data suggest that some of the techniques used in cases of extensive DNA fragmentation can also be of help in those of epigenetic modifications; however, further progress will depend on the availability of more reliable diagnostic methods with which it will be possible to evaluate the effects of different therapeutic interventions.
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12
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Joly F, Ahmed-Lecheheb D, Thiery-Vuillemin A, Orillard E, Coquan E. [Side effects of chemotherapy for testicular cancers and post-cancer follow-up]. Bull Cancer 2019; 106:805-811. [PMID: 31171345 DOI: 10.1016/j.bulcan.2019.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 04/15/2019] [Accepted: 04/15/2019] [Indexed: 01/30/2023]
Abstract
Testicular cancers are the most frequent and the most curable cancers in young men. Treatments of these cancers represent a great success with cure rate over to 95 %. However, chemotherapy side effects may occur during or after several years post-treatment. This review aimed to highlight complications and physical and psychological side effects occurring mainly after chemotherapy treatment for testicular cancer, and to propose a personalized post-cancer plan specific for patients treated for testicular cancer. Treatments of these cancers can cause short-term complications (asthenia, nausea, vomiting, alopecia..). These side effects disappear within a few months after the end of the treatments. Late complications may occur several years post-treatment. Cardiovascular disease, metabolic syndrome and secondary neoplasia represent the most severe late effects among patients treated for testicular cancer. Given the increased incidence of these chemotherapy-induced side effects, it is indispensable to establish a specific follow up which must include a particular vigilance on the risk of occurrence of second cancer, a follow-up of the cardio-vascular risk factors, pulmonary and auditory follow-up, and early detection of psychosocial disorders.
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Affiliation(s)
- Florence Joly
- UNICANCER, Centre François Baclesse, Clinical Research Department and Medical Department, avenue général Harris, 14076 Caen, France; Inserm, U1086, 14076 Caen, France; Université de Caen Basse-Normandie, UMR-S1077, 14000 Caen, France; CHU de Caen, Department of Oncology, 14000 Caen, France.
| | - Djihane Ahmed-Lecheheb
- UNICANCER, Centre François Baclesse, Clinical Research Department and Medical Department, avenue général Harris, 14076 Caen, France; Inserm, U1086, 14076 Caen, France
| | | | - Emeline Orillard
- CHU Jean-Minjoz, Département Oncologie médicale, Boulevard Fleming, 25030 Besançon, France
| | - Elodie Coquan
- UNICANCER, Centre François Baclesse, Clinical Research Department and Medical Department, avenue général Harris, 14076 Caen, France
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Beaud H, Tremblay AR, Chan PTK, Delbes G. Sperm DNA Damage in Cancer Patients. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1166:189-203. [PMID: 31301053 DOI: 10.1007/978-3-030-21664-1_11] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Fertility is a growing healthcare issue for a rising number of cancer survivors. In men, cancer itself and its treatment can negatively affect spermatogenesis by targeting the dividing spermatogonia and their cellular environment, ultimately leading to a reduction of testicular germ cells and sperm count. Experimental data and prospective longitudinal studies have shown that sperm production can recover after cancer treatment. But despite this, yet unpredictable, recovery in sperm production, cancer survivors are more at risk to produce sperm with aneuploidy, DNA damage, abnormal chromatin structure, and epigenetic defects even 2 years post-treatment. Sperm DNA alteration is of clinical concern, as these patients may father children or seek assisted reproduction technologies (ART) using gametes with damaged genome that could result in adverse progeny outcomes. Interestingly, large cohort studies revealed lower birth rate but no significant impact on the health of the children born from male cancer survivors (naturally or using ART). Nevertheless, a better understanding of how cocktail of chemotherapy and new anticancer agents affect spermatogenesis and sperm quality is needed to reduce side effects. Moreover, developing new fertility preservation strategies is essential as sperm cryopreservation before treatment is currently the only option but does not apply for prepubertal/young postpubertal patients.
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Affiliation(s)
- Hermance Beaud
- Institut national de la recherche scientifique, Centre INRS - Institut Armand-Frappier, QC, Canada
| | - Amelie R Tremblay
- Institut national de la recherche scientifique, Centre INRS - Institut Armand-Frappier, QC, Canada
| | - Peter T K Chan
- Division of Urology, McGill University Health Center, QC, Canada
| | - Geraldine Delbes
- Institut national de la recherche scientifique, Centre INRS - Institut Armand-Frappier, QC, Canada.
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Sperm DNA Fragmentation: Mechanisms of Origin. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1166:75-85. [DOI: 10.1007/978-3-030-21664-1_5] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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15
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Moody JA, Ahmed K, Yap T, Minhas S, Shabbir M. Fertility managment in testicular cancer: the need to establish a standardized and evidence-based patient-centric pathway. BJU Int 2018; 123:160-172. [DOI: 10.1111/bju.14455] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Jemma A. Moody
- GKT School of Medical Education; King's College London; London UK
- College of Medical and Dental Sciences; University of Birmingham; Birmingham UK
| | - Kamran Ahmed
- GKT School of Medical Education; King's College London; London UK
- Department of Urology; Guy's Hospital; London UK
| | - Tet Yap
- Department of Urology; Guy's Hospital; London UK
| | - Suks Minhas
- Imperial College Healthcare; NHS Trust; London UK
| | - Majid Shabbir
- GKT School of Medical Education; King's College London; London UK
- Department of Urology; Guy's Hospital; London UK
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16
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Paoli D, Pallotti F, Lenzi A, Lombardo F. Fatherhood and Sperm DNA Damage in Testicular Cancer Patients. Front Endocrinol (Lausanne) 2018; 9:506. [PMID: 30271379 PMCID: PMC6146098 DOI: 10.3389/fendo.2018.00506] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 08/13/2018] [Indexed: 01/28/2023] Open
Abstract
Testicular cancer (TC) is one of the most treatable of all malignancies and the management of the quality of life of these patients is increasingly important, especially with regard to their sexuality and fertility. Survivors must overcome anxiety and fears about reduced fertility and possible pregnancy-related risks as well as health effects in offspring. There is thus a growing awareness of the need for reproductive counseling of cancer survivors. Studies found a high level of sperm DNA damage in TC patients in comparison with healthy, fertile controls, but no significant difference between these patients and infertile patients. Sperm DNA alterations due to cancer treatment persist from 2 to 5 years after the end of the treatment and may be influenced by both the type of therapy and the stage of the disease. Population studies reported a slightly reduced overall fertility of TC survivors and a more frequent use of ART than the general population, with a success rate of around 50%. Paternity after a diagnosis of cancer is an important issue and reproductive potential is becoming a major quality of life factor. Sperm chromatin instability associated with genome instability is the most important reproductive side effect related to the malignancy or its treatment. Studies investigating the magnitude of this damage could have a considerable translational importance in the management of cancer patients, as they could identify the time needed for the germ cell line to repair nuclear damage and thus produce gametes with a reduced risk for the offspring.
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Kumar K, Lewis S, Vinci S, Riera-Escamilla A, Fino MG, Tamburrino L, Muratori M, Larsen P, Krausz C. Evaluation of sperm DNA quality in men presenting with testicular cancer and lymphoma using alkaline and neutral Comet assays. Andrology 2017; 6:230-235. [DOI: 10.1111/andr.12429] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Revised: 07/14/2017] [Accepted: 08/21/2017] [Indexed: 02/03/2023]
Affiliation(s)
- K. Kumar
- Centre for Public Health; Queen's University Belfast; Belfast Northern Ireland UK
| | - S. Lewis
- Centre for Public Health; Queen's University Belfast; Belfast Northern Ireland UK
| | - S. Vinci
- Sexual Medicine and Andrology Unit; Department of Clinical and Experimental Biomedical Sciences “Mario Serio”; University of Florence; Florence Italy
| | - A. Riera-Escamilla
- Sexual Medicine and Andrology Unit; Department of Clinical and Experimental Biomedical Sciences “Mario Serio”; University of Florence; Florence Italy
| | - M.-G. Fino
- Sexual Medicine and Andrology Unit; Department of Clinical and Experimental Biomedical Sciences “Mario Serio”; University of Florence; Florence Italy
| | - L. Tamburrino
- Sexual Medicine and Andrology Unit; Department of Clinical and Experimental Biomedical Sciences “Mario Serio”; University of Florence; Florence Italy
| | - M. Muratori
- Sexual Medicine and Andrology Unit; Department of Clinical and Experimental Biomedical Sciences “Mario Serio”; University of Florence; Florence Italy
| | | | - C. Krausz
- Sexual Medicine and Andrology Unit; Department of Clinical and Experimental Biomedical Sciences “Mario Serio”; University of Florence; Florence Italy
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Pourmasumi S, Sabeti P, Rahiminia T, Mangoli E, Tabibnejad N, Talebi AR. The etiologies of sperm DNA abnormalities in male infertility: An assessment and review. Int J Reprod Biomed 2017. [DOI: 10.29252/ijrm.15.6.331] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Marchlewska K, Filipiak E, Walczak-Jedrzejowska R, Oszukowska E, Sobkiewicz S, Wojt M, Chmiel J, Kula K, Slowikowska-Hilczer J. Sperm DNA Fragmentation Index and Hyaluronan Binding Ability in Men from Infertile Couples and Men with Testicular Germ Cell Tumor. BIOMED RESEARCH INTERNATIONAL 2016; 2016:7893961. [PMID: 27999814 PMCID: PMC5143696 DOI: 10.1155/2016/7893961] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 10/26/2016] [Indexed: 12/23/2022]
Abstract
Objective. To investigate sperm DNA fragmentation and sperm functional maturity in men from infertile couples (IC) and men with testicular germ cell tumor (TGCT). Materials and Methods. Semen samples were collected from 312 IC men and 23 men with TGCT before unilateral orchiectomy and oncological treatment. The sperm chromatin dispersion test was performed to determine DNA fragmentation index (DFI) and the ability of sperm to bind with hyaluronan (HA) was assessed. Results. In comparison with the IC men, the men with TGCT had a higher percentage of sperm with fragmented DNA (median 28% versus 21%; p < 0.01) and a lower percentage of HA-bound sperm (24% versus 66%; p < 0.001). Normal results of both analyses were observed in 24% of IC men and 4% of men with TGCT. Negative Spearman's correlations were found between DFI and the percentage of HA-bound sperm in the whole group and in IC subjects and those with TGCT analyzed separately. Conclusions. Approximately 76% of IC men and 96% with TGCT awaiting orchiectomy demonstrated DNA fragmentation and/or sperm immaturity. We therefore recommend sperm banking after unilateral orchiectomy, but before irradiation and chemotherapy; the use of such a deposit appears to be a better strategy to obtain functionally efficient sperms.
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Affiliation(s)
- Katarzyna Marchlewska
- Department of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland
| | - Eliza Filipiak
- Department of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland
| | | | | | | | | | | | - Krzysztof Kula
- Department of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland
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Zhu Y, Gao G, Xia L, Li X, Wu X, Her C, Xu K. The polymorphichMSH5C85T allele augments radiotherapy-induced spermatogenic impairment. Andrology 2016; 4:873-9. [DOI: 10.1111/andr.12203] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 03/28/2016] [Accepted: 03/29/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Y. Zhu
- Department of Laboratory Medicine; Xiangya School of Medicine; Central South University; Changsha China
| | - G. Gao
- Department of Laboratory Medicine; Xiangya School of Medicine; Central South University; Changsha China
| | - L. Xia
- Department of Tumor; The Third Xiangya Hospital; Central South University; Changsha China
| | - X. Li
- Department of Tumor; The Third Xiangya Hospital; Central South University; Changsha China
| | - X. Wu
- School of Molecular Biosciences; Washington State University; Pullman WA USA
| | - C. Her
- School of Molecular Biosciences; Washington State University; Pullman WA USA
| | - K. Xu
- Department of Laboratory Medicine; Xiangya School of Medicine; Central South University; Changsha China
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Namekawa T, Imamoto T, Kato M, Sazuka T, Fuse M, Sakamoto S, Kawamura K, Ichikawa T. Testicular function among testicular cancer survivors treated with cisplatin-based chemotherapy. Reprod Med Biol 2016; 15:175-181. [PMID: 29259434 PMCID: PMC5715851 DOI: 10.1007/s12522-015-0232-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 12/19/2015] [Indexed: 10/22/2022] Open
Abstract
Purpose The aim of our study was to identify the clinical predictors of spermatogenesis recovery in testicular cancer (TC) patients after chemotherapy and to determine the recuperation period for spermatogenesis. Methods Patients treated for TC from January 1982 to November 2001 at Chiba University Hospital were retrospectively assessed. Thirty-five patients who met the following criteria were examined-(i) underwent both high orchiectomy and cisplatin-based chemotherapy; (ii) had semen analyses and hormonal measurements; and (iii) were alive with no evidence of disease. Clinical variables associated with normalization of spermatogenesis after chemotherapy were examined. Time to recover normospermia was also evaluated using Kaplan-Meier analysis. Results The observation period was 13.3 ± 5.6 years. Reappearance of sperm was confirmed in 85.7 % of patients, and 54.3 % of patients recovered normospermia. Age at diagnosis <25 years (p = 0.0057), number of chemotherapy cycles <4 cycles (p = 0.0042), and follicle-stimulating hormone at the end of chemotherapy <18 mIU/ml (p = 0.0220) were independent factors related to post-chemotherapy normalization of semen findings. The median (95 % CI) time to recover normospermia was 40 (range 22-96) months. Conclusions These findings help to predict whether spermatogenesis will recover and its timing. They may also help clinicians identify and manage TC patients at a higher risk of prolonged azoospermia after chemotherapy.
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Affiliation(s)
- Takeshi Namekawa
- Department of UrologyGraduate School of Medicine, Chiba University1‐8‐1 Inohana‐cho, Chuo‐ku260‐8670ChibaJapan
| | - Takashi Imamoto
- Department of UrologyGraduate School of Medicine, Chiba University1‐8‐1 Inohana‐cho, Chuo‐ku260‐8670ChibaJapan
| | - Mayuko Kato
- Department of UrologyGraduate School of Medicine, Chiba University1‐8‐1 Inohana‐cho, Chuo‐ku260‐8670ChibaJapan
| | - Tomokazu Sazuka
- Department of UrologyGraduate School of Medicine, Chiba University1‐8‐1 Inohana‐cho, Chuo‐ku260‐8670ChibaJapan
| | - Miki Fuse
- Department of UrologyGraduate School of Medicine, Chiba University1‐8‐1 Inohana‐cho, Chuo‐ku260‐8670ChibaJapan
| | - Shinichi Sakamoto
- Department of UrologyGraduate School of Medicine, Chiba University1‐8‐1 Inohana‐cho, Chuo‐ku260‐8670ChibaJapan
| | - Koji Kawamura
- Department of UrologyGraduate School of Medicine, Chiba University1‐8‐1 Inohana‐cho, Chuo‐ku260‐8670ChibaJapan
| | - Tomohiko Ichikawa
- Department of UrologyGraduate School of Medicine, Chiba University1‐8‐1 Inohana‐cho, Chuo‐ku260‐8670ChibaJapan
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22
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Ghezzi M, Berretta M, Bottacin A, Palego P, Sartini B, Cosci I, Finos L, Selice R, Foresta C, Garolla A. Impact of Bep or Carboplatin Chemotherapy on Testicular Function and Sperm Nucleus of Subjects with Testicular Germ Cell Tumor. Front Pharmacol 2016; 7:122. [PMID: 27242529 PMCID: PMC4865517 DOI: 10.3389/fphar.2016.00122] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 04/27/2016] [Indexed: 01/25/2023] Open
Abstract
Young males have testicular germ cells tumors (TGCT) as the most common malignancy and its incidence is increasing in several countries. Besides unilateral orchiectomy (UO), the treatment of TGCT may include surveillance, radiotherapy, or chemotherapy (CT), basing on tumor histology and stage of disease. It is well known that both radio and CT may have negative effects on testicular function, affecting spermatogenesis, and sex hormones. Many reports investigated these aspects in patients treated with bleomycin, etoposide, and cisplatin (BEP), after UO. In contrast no data are available on the side effects of carboplatin treatment in these patients. We included in this study 212 consecutive subjects who undergone to sperm banking at our Andrology and Human Reproduction Unit after UO for TGCT. Hundred subjects were further treated with one or more BEP cycles (BEP-group), 54 with carboplatin (CARB group), and 58 were just surveilled (S-group). All patients were evaluated for seminal parameters, sperm aneuploidy, sperm DNA, sex hormones, volume of the residual testis at baseline (T0) and after 12 (T1) and 24 months (T2) from UO or end of CT. Seminal parameters, sperm aneuploidies, DNA status, gonadic hormones, and testicular volume at baseline were not different between groups. At T1, we observed a significant reduction of sperm concentration and sperm count in the BEP group versus baseline and versus both Carb and S-group. A significant increase of sperm aneuploidies was present at T1 in the BEP group. Similarly, the same group at 1 had altered sperm DNA integrity and fragmentation compared with baseline, S-group and Carb group. These alterations were persistent after 2 years from the end of BEP treatment. Despite a slight improvement at T2, the BEP group had still higher percentages of sperm aneuploidies than other groups. No impairment of sperm aneuploidies and DNA status were observed in the Carb group both after 1 and 2 years from the end of treatment. Despite preliminary, these data demonstrate that in selected patients with TGCTs CT with carboplatin represents a therapeutic option that that seems to not affect sex hormones, spermatogenesis, and sperm nucleus.
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Affiliation(s)
- Marco Ghezzi
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of PadovaPadova, Italy
- Istituto Oncologico Veneto – Istituto di Ricovero e Cura a Carattere ScientificoPadova, Italy
| | - Massimiliano Berretta
- Department of Medical Oncology, CRO Aviano National Cancer Institute IRCCSAviano, Italy
| | - Alberto Bottacin
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of PadovaPadova, Italy
| | - Pierfrancesco Palego
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of PadovaPadova, Italy
| | - Barbara Sartini
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of PadovaPadova, Italy
| | - Ilaria Cosci
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of PadovaPadova, Italy
| | - Livio Finos
- Department of Statistical Sciences, University of PadovaPadova, Italy
| | - Riccardo Selice
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of PadovaPadova, Italy
| | - Carlo Foresta
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of PadovaPadova, Italy
| | - Andrea Garolla
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of PadovaPadova, Italy
- Istituto Oncologico Veneto – Istituto di Ricovero e Cura a Carattere ScientificoPadova, Italy
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23
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Kryukov GV, Bielski CM, Samocha K, Fromer M, Seepo S, Gentry C, Neale B, Garraway LA, Sweeney CJ, Taplin ME, Van Allen EM. Genetic Effect of Chemotherapy Exposure in Children of Testicular Cancer Survivors. Clin Cancer Res 2015; 22:2183-9. [PMID: 26631610 DOI: 10.1158/1078-0432.ccr-15-2317] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 11/09/2015] [Indexed: 11/16/2022]
Abstract
PURPOSE Cancer survivors express anxiety that chemotherapy exposure may lead to transmissible genetic damage in posttreatment children. Preclinical models suggest that chemotherapy exposure may result in considerable genomic alterations in postexposure progeny. Epidemiologic studies have not demonstrated a significant increase in congenital abnormalities in posttreatment children of cancer survivors, but the inherited genome-wide effect of chemotherapy exposure in humans is unknown. EXPERIMENTAL DESIGN Two testicular cancer survivors cured with chemotherapy who had children pre- and postexposure without sperm banking were identified. Familial germline whole genome sequencing (WGS) was performed for these families, and analytic methods were utilized to identify de novo alterations, including mutations, recombinations, and structural rearrangements in the pre- and postexposure offspring. RESULTS No increase in de novo germline mutations in postexposure children compared with their preexposure siblings was found. Furthermore, there were no increased short insertion/deletions, recombination frequency, or structural rearrangements in these postexposure children. CONCLUSIONS In two families of male cancer survivors, there was no transmissible genomic impact of significant mutagenic exposure in postexposure children. This study may provide possible reassuring evidence for patients undergoing chemotherapy who are unable to have pretreatment sperm cryopreservation. Expanded cohorts that utilize WGS to identify environmental exposure effects on the inherited genome may inform the generalizability of these results. Clin Cancer Res; 22(9); 2183-9. ©2015 AACR.
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Affiliation(s)
- Gregory V Kryukov
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts. Division of Genetics, Brigham and Women's Hospital, Boston, Massachusetts. Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Craig M Bielski
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Kaitlin Samocha
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts. Analytical and Translational Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts
| | - Menachem Fromer
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts. Analytical and Translational Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts. Department of Genetics and Genomic Sciences, Mount Sinai School of Medicine, New York, New York. Department of Psychiatry, Mount Sinai School of Medicine, New York, New York
| | - Sara Seepo
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Carleen Gentry
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Benjamin Neale
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts. Analytical and Translational Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts
| | - Levi A Garraway
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts. Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | | | - Mary-Ellen Taplin
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
| | - Eliezer M Van Allen
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts. Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
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Wang Z, Yan B, Wei YB, Yin Z, Zhou KQ, Yang JR. Adult metastatic yolk sac tumor descending from an intra-abdominal testis: A case report and review of the literature. Oncol Lett 2015; 10:3647-3650. [PMID: 26788184 DOI: 10.3892/ol.2015.3817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 09/18/2015] [Indexed: 01/06/2023] Open
Abstract
Pure yolk sac tumors are extremely rare in adults; to the best of our knowledge, <20 cases have been reported. Multiple metastases originating from a pure yolk sac testicular tumor, descending from an intra-abdominal testis, are additionally extremely rare. In the present case, a man exhibiting a 30-year history of cryptorchidism and indirect inguinal hernia, was admitted to the Department of Urology (The Second Xiangya Hospital, Changsha, China) due to a mass that had descended from the abdominal cavity 7 months previously. Elevated levels of specific serum marker (α-fetoprotein, lactate dehydrogenase and human chorionic gonadotropin) did not indicate potential testicular germ cell types prior to surgery and pathological examination. Pathological results and immunohistochemistry revealed a testicular pure yolk sac tumor subsequent to surgery. The present case report and literature review describes the typical characteristics of an adult testicular yolk sac tumor, as well as the diagnosis and management of the disease.
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Affiliation(s)
- Zhao Wang
- Department of Urology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P.R. China; Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
| | - Bin Yan
- Department of Urology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P.R. China
| | - Yong-Bao Wei
- Department of Urology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P.R. China
| | - Zhuo Yin
- Department of Urology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P.R. China
| | - Ke-Qin Zhou
- Department of Urology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P.R. China
| | - Jin-Rui Yang
- Department of Urology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P.R. China
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