Mp47-08 Impact of Hypogonadism on Radical Cystectomy Outcomes

You have accessJournal of UrologySexual Function/Dysfunction: Medical, Hormonal & Non-surgical Therapy I (MP47)1 May 2024MP47-08 IMPACT OF HYPOGONADISM ON RADICAL CYSTECTOMY OUTCOMES Ekamjit S. Deol, Grant Henning, Vidit Sharma, Spyridon Basourakos, Matthew K. Tollefson, Robert Tarrell, Prabin Thapa, R. Houston Thompson, Robert J. Karnes, Sevann Helo, Matthew J. Ziegelmann, Tobias S. Kohler, Stephen A. Boorjian, Igor Frank, and Abhinav Khanna Ekamjit S. DeolEkamjit S. Deol , Grant HenningGrant Henning , Vidit SharmaVidit Sharma , Spyridon BasourakosSpyridon Basourakos , Matthew K. TollefsonMatthew K. Tollefson , Robert TarrellRobert Tarrell , Prabin ThapaPrabin Thapa , R. Houston ThompsonR. Houston Thompson , Robert J. KarnesRobert J. Karnes , Sevann HeloSevann Helo , Matthew J. ZiegelmannMatthew J. Ziegelmann , Tobias S. KohlerTobias S. Kohler , Stephen A. BoorjianStephen A. Boorjian , Igor FrankIgor Frank , and Abhinav KhannaAbhinav Khanna View All Author Informationhttps://doi.org/10.1097/01.JU.0001008880.11564.10.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Urothelial carcinoma of the bladder (UCB) is among the most lethal urologic malignancies, and radical cystectomy (RC) is associated with significant peri-operative morbidity. Prior literature has suggested that hypogonadism drives maladaptive body composition changes and decreased physiological reserve. However, the relationship between testosterone levels and outcomes following RC have not been thoroughly explored. Herein, we aim to examine the association between testosterone levels and both peri-op and longitudinal oncologic outcomes following RC. METHODS: Patients who underwent RC for UCB between 1980-2020 were identified using our institutional prospectively maintained clinical registry. Patients were included if they had at least one pre-op serum testosterone level available for review. Patients were defined as hypogonadal if their pre-op serum testosterone level was ≤300 ng/dL. Survival analysis using Cox regression was used to explore outcomes of interest. RESULTS: A total of 99 patients were included, among whom 43 patients were hypogonadal and 56 were eugonadal. Median pre-op serum testosterone was 192.0 (IQR: 43.0 - 284.0) ng/dL and 505.5 (IQR: 385.0 - 569.0) ng/dL in the hypogonadal and eugonadal groups, respectively. At a median follow-up of 4.0 (IQR: 1.0 – 9.7) years, 54 patients died, including 34 who died of urothelial carcinoma. There were no significant between-group differences in patient age (p=0.2507), pathologic T-stage (p=0.4656), nor use of neoadjuvant chemotherapy (p=0.16). Hypogonadal patients were more likely to have received androgen deprivation therapy prior to RC (p<0.0001). On Cox survival analyses, patients with pre-op hypogonadism had worse overall survival (HR: 2.33 CI: 1.34 - 3.32, p=0.0028) and worse cancer-specific survival (HR: 2.35 CI: 1.17 – 3:53, p=0.0168) compared with eugonadal patients. There was no statistically significant difference in metastasis-free survival nor peri-operative surgical outcomes between groups. CONCLUSIONS: Patients with pre-op hypogonadism experienced worse cancer-specific and overall survival after RC as compared to eugonadal patients. This hypothesis generating study highlights the need for further prospective studies exploring the impact of serum testosterone levels and peri-op testosterone replacement therapy on RC outcomes. Download PPT Source of Funding: Thomas P. and Elizabeth S. Grainger Urology Fellowship Fund © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e765 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Ekamjit S. Deol More articles by this author Grant Henning More articles by this author Vidit Sharma More articles by this author Spyridon Basourakos More articles by this author Matthew K. Tollefson More articles by this author Robert Tarrell More articles by this author Prabin Thapa More articles by this author R. Houston Thompson More articles by this author Robert J. Karnes More articles by this author Sevann Helo More articles by this author Matthew J. Ziegelmann More articles by this author Tobias S. Kohler More articles by this author Stephen A. Boorjian More articles by this author Igor Frank More articles by this author Abhinav Khanna More articles by this author Expand All Advertisement PDF downloadLoading ...