Testosterone replacement therapy reduces biochemical recurrence after radical prostatectomy

Area of Science:

• Urology
• Oncology
• Endocrinology

Background:

• Prostate cancer is a significant health concern, with biochemical recurrence (BCR) after radical prostatectomy (RP) being a key indicator of treatment outcome.
• Testosterone replacement therapy (TRT) is sometimes considered for men with hypogonadism, but its role in managing BCR after RP is not fully established.

Purpose of the Study:

• To evaluate the risk of prostate cancer BCR after RP in men receiving versus not receiving TRT.
• To assess the impact of TRT on the time to BCR in this patient population.

Main Methods:

• A retrospective analysis of 850 patients who underwent RP by a single surgeon.
• 152 patients with low preoperative calculated free testosterone (cFT) and delayed sexual function recovery received TRT and were matched to 419 control patients.
• Comparison of BCR rates and time to recurrence using univariate and multivariate regression, including Cox regression analysis.

Main Results:

• After a median follow-up of 3.5 years, BCR occurred in 7.2% of the TRT group versus 12.6% of the control group.
• TRT was an independent predictor of recurrence-free survival, with patients on TRT being approximately 54% less likely to recur.
• TRT delayed the time to recurrence by an average of 1.5 years in men who were destined to recur.

Conclusions:

• TRT after RP significantly reduced BCR and delayed its time to recurrence in this patient cohort.
• No general health complications were associated with TRT in this study.
• These findings are hypothesis-generating and warrant confirmation through multi-centered, prospective randomized controlled trials.