Gynecomastia in testicular cancer patients prognostic and therapeutic implications

✍ Scribed by Alexander Tseng JR; Sandra J. Horning; Fuad S. Freiha; Kenneth J. Resser; John F. Hannigan JR; Frank M. Torti

• Publisher: John Wiley and Sons
• Year: 1985
• Tongue: English
• Weight: 441 KB
• Volume: 56
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/1097-0142(19851115)56:10<2534::aid-cncr2820561036>3.0.co;2-q

✦ Synopsis

Eighty-one patients with advanced testicular cancer were evaluated for gynecomastia or severe breast tenderness at diagnosis and after platinum-based chemotherapy. The prognostic significance of gynecomastia in these two settings was explored. At presentation, 10% (8 patients) had gynecomastia or breast tenderness and elevated HCG levels. The likelihood of gynecomastia was greater with increasing HCC level (P = 0.002). However, gynecomastia at presentation was a more powerful independent discriminant of poor survival than the initial HCG level by multivariate analysis (P = 0.004). Fifteen percent (12 patients) developed transient gynecomastia after chemotherapy not attributable to other known causes. HCG levels were normal. Endocrine evaluation typically revealed elevated FSH, LH, and estradiol/ testosterone ratios. This may have reflected damage to testicular germinal epithelium. All 12 patients are alive without disease in contrast to the 8 patients who had gynecomastia at diagnosis. Therapy decisions should therefore be based on the time of onset of gynecomastia and in the context of appropriate clinical markers and evaluation.