Frontiers in Endocrinology (Jan 2024)
Hypogonadism and sexual function in men affected by adrenocortical carcinoma under mitotane therapy
- Letizia Canu,
- Letizia Canu,
- Letizia Canu,
- Letizia Canu,
- Clotilde Sparano,
- Clotilde Sparano,
- Lara Naletto,
- Giuseppina De Filpo,
- Giulia Cantini,
- Giulia Cantini,
- Giulia Cantini,
- Elena Rapizzi,
- Elena Rapizzi,
- Elena Rapizzi,
- Serena Martinelli,
- Serena Martinelli,
- Serena Martinelli,
- Tonino Ercolino,
- Tonino Ercolino,
- Tonino Ercolino,
- Francesca Cioppi,
- Alessandro Fantoni,
- Lorenzo Zanatta,
- Lorenzo Zanatta,
- Alessandro Terreni,
- Massimo Mannelli,
- Massimo Mannelli,
- Massimo Mannelli,
- Michaela Luconi,
- Michaela Luconi,
- Michaela Luconi,
- Mario Maggi,
- Mario Maggi,
- Mario Maggi,
- Mario Maggi,
- Francesco Lotti
Affiliations
- Letizia Canu
- Endocrinology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, Florence, Italy
- Letizia Canu
- Endocrinology Unit, Careggi University Hospital (AOUC), Florence, Italy
- Letizia Canu
- Centro di Ricerca e Innovazione sulle Patologie Surrenaliche, AOU Careggi, Florence, Italy
- Letizia Canu
- Center of Excellence of European Network for the Study of Adrenal Tumors (ENS@T), Florence, Italy
- Clotilde Sparano
- Endocrinology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, Florence, Italy
- Clotilde Sparano
- Endocrinology Unit, Careggi University Hospital (AOUC), Florence, Italy
- Lara Naletto
- Endocrinology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, Florence, Italy
- Giuseppina De Filpo
- Endocrinology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, Florence, Italy
- Giulia Cantini
- Endocrinology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, Florence, Italy
- Giulia Cantini
- Centro di Ricerca e Innovazione sulle Patologie Surrenaliche, AOU Careggi, Florence, Italy
- Giulia Cantini
- Center of Excellence of European Network for the Study of Adrenal Tumors (ENS@T), Florence, Italy
- Elena Rapizzi
- Centro di Ricerca e Innovazione sulle Patologie Surrenaliche, AOU Careggi, Florence, Italy
- Elena Rapizzi
- Center of Excellence of European Network for the Study of Adrenal Tumors (ENS@T), Florence, Italy
- Elena Rapizzi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Serena Martinelli
- Endocrinology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, Florence, Italy
- Serena Martinelli
- Centro di Ricerca e Innovazione sulle Patologie Surrenaliche, AOU Careggi, Florence, Italy
- Serena Martinelli
- Center of Excellence of European Network for the Study of Adrenal Tumors (ENS@T), Florence, Italy
- Tonino Ercolino
- Endocrinology Unit, Careggi University Hospital (AOUC), Florence, Italy
- Tonino Ercolino
- Centro di Ricerca e Innovazione sulle Patologie Surrenaliche, AOU Careggi, Florence, Italy
- Tonino Ercolino
- Center of Excellence of European Network for the Study of Adrenal Tumors (ENS@T), Florence, Italy
- Francesca Cioppi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Alessandro Fantoni
- Endocrinology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, Florence, Italy
- Lorenzo Zanatta
- Endocrinology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, Florence, Italy
- Lorenzo Zanatta
- Endocrinology Unit, Careggi University Hospital (AOUC), Florence, Italy
- Alessandro Terreni
- Department of Laboratory, Careggi University Hospital (AOUC), Florence, Italy
- Massimo Mannelli
- Endocrinology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, Florence, Italy
- Massimo Mannelli
- Centro di Ricerca e Innovazione sulle Patologie Surrenaliche, AOU Careggi, Florence, Italy
- Massimo Mannelli
- Center of Excellence of European Network for the Study of Adrenal Tumors (ENS@T), Florence, Italy
- Michaela Luconi
- Endocrinology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, Florence, Italy
- Michaela Luconi
- Centro di Ricerca e Innovazione sulle Patologie Surrenaliche, AOU Careggi, Florence, Italy
- Michaela Luconi
- Center of Excellence of European Network for the Study of Adrenal Tumors (ENS@T), Florence, Italy
- Mario Maggi
- Endocrinology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, Florence, Italy
- Mario Maggi
- Endocrinology Unit, Careggi University Hospital (AOUC), Florence, Italy
- Mario Maggi
- Centro di Ricerca e Innovazione sulle Patologie Surrenaliche, AOU Careggi, Florence, Italy
- Mario Maggi
- Center of Excellence of European Network for the Study of Adrenal Tumors (ENS@T), Florence, Italy
- Francesco Lotti
- Andrology, Female Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, Florence, Italy
- DOI
- https://doi.org/10.3389/fendo.2023.1320722
- Journal volume & issue
-
Vol. 14
Abstract
PurposeAdrenocortical carcinoma (ACC) is a rare and aggressive tumor. ACC male patients under adjuvant mitotane therapy (AMT) frequently develop hypogonadism, however sexual function has never been assessed in this setting. The aim of this retrospective study was to evaluate in AMT treated ACC patients the changes in Luteinizing hormone (LH), Sex Hormone Binding Globulin (SHBG), total testosterone (TT) and calculated free testosterone (cFT), the prevalence and type of hypogonadism and sexual function, the latter before and after androgen replacement therapy (ART).MethodsLH, SHBG, TT and cFT were assessed in ten ACC patients at baseline (T0) and six (T1), twelve (T2), and eighteen (T3) months after AMT. At T3, ART was initiated in eight hypogonadal patients, and LH, SHBG, TT and cFT levels were evaluated after six months (T4). In six patients, sexual function was evaluated before (T3) and after (T4) ART using the International Index of Erectile Function-15 (IIEF-15) questionnaire.ResultsUnder AMT we observed higher SHBG and LH and lower cFT levels at T1-T3 compared to T0 (all p<0.05). At T3, hypergonadotropic hypogonadism and erectile dysfunction (ED) were detected in 80% and 83.3% of cases. At T4, we observed a significant cFT increase in men treated with T gel, and a significant improvement in IIEF-15 total and subdomains scores and ED prevalence (16.7%) in men under ART.ConclusionAMT was associated with hypergonatropic hypogonadism and ED, while ART led to a significant improvement of cFT levels and sexual function in the hypogonadal ACC patients. Therefore, we suggest to evaluate LH, SHBG, TT and cFT and sexual function during AMT, and start ART in the hypogonadal ACC patients with sexual dysfunction.
Keywords
- adrenocortical carcinoma
- mitotane
- hypergonadotropic hypogonadism
- androgen replacement therapy
- sexual dysfunction
