Erectile Dysfunction in Germ Cell Tumor Survivors

Purpose: Germ cell tumors (GCTs) are the most common malignant neoplasms in adolescents and young adults, and most patients with these tumors can be completely cured. Therefore, maintaining quality of life (QOL) is important. Erectile dysfunction (ED) is one factor that reduces the QOL of GCT survivors. We aimed to clarify the relationship between ED and age, follow-up period, serum levels of hormones, and treatment methods for GCT survivors. Materials and Methods: We evaluated ED using the Sexual Health Inventory for Men questionnaire (SHIM) and measured serum levels of hormones in survivors after GCT treatment. The relationships between the SHIM score responses and age, serum levels of hormones, follow-up period, and treatment methods were assessed using a logistic analysis. Results: Fifty-two GCT survivors were enrolled and 46 survivors completed the SHIM. The median age, follow-up period, and SHIM score were 38 years, 35 months, and 18, respectively. Regarding the SHIM scores, 85% had scores <22 and 46% had scores <17. The percentage of SHIM scores <17 was 69% in patients with under 2 years of follow-up. It significantly improved to 33% in patients with over 2 years of follow-up. The multivariate analysis identified the follow-up period as an independent factor for SHIM scores <17. Age, serum levels of hormone, and treatment method were not significant factors for SHIM scores <17. Conclusions: Improvement of SHIM score can be expected after GCT treatment regardless of age, serum levels of hormone, and treatment method.

研究目的：生殖细胞肿瘤（Germ cell tumors, GCTs）是青少年与年轻成人中最常见的恶性肿瘤，多数此类肿瘤患者可实现完全治愈。因此，维持生活质量（Quality of Life, QOL）具有重要临床意义。勃起功能障碍（Erectile dysfunction, ED）是降低生殖细胞肿瘤幸存者生活质量的影响因素之一。本研究旨在明确生殖细胞肿瘤幸存者的勃起功能障碍与年龄、随访时长、血清激素水平及治疗方式之间的关联。
材料与方法：本研究采用男性性健康问卷（Sexual Health Inventory for Men, SHIM）评估受试者的勃起功能障碍情况，并检测生殖细胞肿瘤治疗后幸存者的血清激素水平。采用logistic回归分析评估SHIM评分结果与年龄、血清激素水平、随访时长及治疗方式之间的关联。
研究结果：本研究共纳入52名生殖细胞肿瘤幸存者，其中46名完成了SHIM问卷。受试者的中位年龄为38岁，中位随访时长为35个月，中位SHIM评分为18分。就SHIM评分而言，85%的受试者评分低于22分，46%的受试者评分低于17分。随访时长不足2年的受试者中，SHIM评分低于17分的比例为69%；而随访时长超过2年的受试者中该比例显著降至33%。多因素分析显示，随访时长是SHIM评分低于17分的独立影响因素；年龄、血清激素水平及治疗方式并非SHIM评分低于17分的显著影响因素。
研究结论：无论年龄、血清激素水平及治疗方式如何，生殖细胞肿瘤患者在接受治疗后均可期待其SHIM评分得到改善。