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Testosterone Therapy in Men After Radical Prostatectomy for Low-Intermediate Organ-Confined Prostate Cancer.
Jose M Flores1,2, Emily A Vertosick2, Carolyn A Salter1,2
1Sexual & Reproductive Medicine Program, Urology Service, Memorial Sloan Kettering Cancer Center, New York, New York.
The Journal of Urology
|September 30, 2024
Summary
Testosterone therapy after radical prostatectomy for prostate cancer does not increase biochemical recurrence rates. This study found no evidence that testosterone replacement therapy causes cancer recurrence in select patients.
Area of Science:
- Urology
- Oncology
- Endocrinology
Background:
- Testosterone therapy (TTh) following radical prostatectomy (RP) for prostate cancer is controversial.
- Men with testosterone deficiency after RP require careful consideration for TTh.
Purpose of the Study:
- To assess the impact of TTh on biochemical recurrence (BCR) rates after RP.
- To evaluate TTh safety in men with low-intermediate organ-confined prostate cancer.
Main Methods:
- Retrospective analysis of 5199 men who underwent RP.
- Cox model with time-dependent covariate for T use, adjusted for clinical factors.
- Landmark analysis initiated 18 weeks post-RP with undetectable PSA.
Main Results:
- 198 patients received T post-RP; 5001 did not.
- T group had more vascular comorbidities.
- Nonsignificant decreased risk of BCR with TTh (HR 0.84, P = 0.5).
- 5-year BCR probability <2% in both groups.
Conclusions:
- TTh can be safely administered to select men post-RP.
- No evidence suggests TTh increases BCR after RP in this cohort.
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