Mp60-12 Long-Term Outcomes of Testosterone Replacement Therapy Delaying Biochemical Recurrence Post-Rarp: Propensity Score-Matched Case-Control Study

You have accessJournal of UrologyProstate Cancer: Advanced (Including Drug Therapy) III (MP60)1 May 2024MP60-12 LONG-TERM OUTCOMES OF TESTOSTERONE REPLACEMENT THERAPY DELAYING BIOCHEMICAL RECURRENCE POST-RARP: PROPENSITY SCORE-MATCHED CASE-CONTROL STUDY Muhammed A. Moukhtar Hammad, Joshua Tran, Tuan T. Nguyen, Mai Xuan Nguyen, Eliad Amini, Hana Sophia Nakamura, Rafael Gevorkyan, Linda My Huynh, Catherine Fung, Faysal A. Yafi, and Thomas E. Ahlering Muhammed A. Moukhtar HammadMuhammed A. Moukhtar Hammad , Joshua TranJoshua Tran , Tuan T. NguyenTuan T. Nguyen , Mai Xuan NguyenMai Xuan Nguyen , Eliad AminiEliad Amini , Hana Sophia NakamuraHana Sophia Nakamura , Rafael GevorkyanRafael Gevorkyan , Linda My HuynhLinda My Huynh , Catherine FungCatherine Fung , Faysal A. YafiFaysal A. Yafi , and Thomas E. AhleringThomas E. Ahlering View All Author Informationhttps://doi.org/10.1097/01.JU.0001008804.84010.ec.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Testosterone Replacement Therapy (TRT) historically has been contraindicated for the management of hypogonadism in men with prostate cancer (PC). Our study aims to investigate the utility of TRT to reduce biochemical recurrence (BCR) in men with PC after a follow-up time of 5.84 years. METHODS: A retrospective review of prospectively collected data between December 2009 and June 2018 undergoing robotic radical prostatectomy (RP) was conducted. We propensity-score matched 151 patients who had TRT post-RP with a calculated free testosterone (cFT) below 25% to 300 post-RP patients not on TRT. Propensity scores were calculated using a multivariable logistic model with age, BMI, Gleason group, PSA, SHIM score, prostate size, pathological stage, total testosterone (TT), sex hormone-binding globulin (SHBG), and cFT. BCR was defined as two consecutive prostate specific antigen (PSA) blood tests >0.2 ng/mL. Cox regression model and Kaplan-Meier (KM) graphs were used to analyze rate and time to BCR. We also used our cox regression model of the time to BCR with truncated time of 10.32 to calculate restricted mean survival time (RMST) for the TRT vs no-TRT groups. Surveys were electronically distributed for secondary cardiac adverse events. RESULTS: No baseline differences in demographics were observed except in TT (p-value=<0.001), cFT (p-value <0.001), and follow-up time (p-value=0.004). In the cox regression multivariate analysis of the no-TRT group, patients with a higher cFT were less likely to have a BCR (p-value=0.013). In the same analysis, patients with a higher GGG, p-stage, and preoperative PSA (p-value=<0.001) were more likely to have a BCR. Patients receiving TRT had 47% reduction in BCR rates (p-value=0.011) after a median follow-up time of 5.84 4.18;7.24 years. Furthermore, our 10-year cox regression model for the time to BCR showed RMST difference between the TRT and no-TRT groups: in patients who did recur, patients on TRT had an increased latency of 0.44 years. 61.18% response rate for the electronic surveys by the TRT group reported no cardiac adverse events. CONCLUSIONS: With long-term follow-up, TRT was observed to have a continuing protective effect in preventing and delaying BCR in patients post-RP when compared to patients who did not receive TRT. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1004 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Muhammed A. Moukhtar Hammad More articles by this author Joshua Tran More articles by this author Tuan T. Nguyen More articles by this author Mai Xuan Nguyen More articles by this author Eliad Amini More articles by this author Hana Sophia Nakamura More articles by this author Rafael Gevorkyan More articles by this author Linda My Huynh More articles by this author Catherine Fung More articles by this author Faysal A. Yafi More articles by this author Thomas E. Ahlering More articles by this author Expand All Advertisement PDF downloadLoading ...