EAU 2019: Testosterone Replacement Therapy Prevents Disease Progression in Men Undergoing Radical Prostatectomy
Maxwell Towe, a clinical research fellow from the University of California, Irvine presents a matched, case-control study of 850 patients undergoing radical prostatectomy by a single surgeon. 152 (18%) of patients with low preoperative free testosterone (FT) levels were placed on TRT to enhance postoperative sexual function recovery.
To match the groups on indicators of biochemical recurrence, Towe and colleagues proportionately matched TRT patients to 419 control patients by pathologic Gleason Grade Group and stage. At a median follow-up time was 3 years, 7/152 (4.6%) and 39/419 (9.3%) patients experienced recurrence in the TRT versus control groups, respectively. In adjusted analysis, TRT was an independent predictor of recurrence-free survival such that patients on TRT were approximately 53% less likely to experience BCR.
Even further, Towe asserts, in patients who are destined to recur, TRT prolonged recurrence-free survival by an average of 1.5 years. In other words, by placing patients on testosterone replacement therapy, should a patient still recur, there would be an increased latency of 1.5 years. This finding is consistent with previous reports of testosterone replacement therapy and suggests a molecular benefit even in these patients.
Although TRT has historically been contraindicated for prostate cancer patients for fear of disease acceleration, Towe’s study demonstrates TRT post-RARP to significantly reduce BCR and prolong recurrence-free survival. These findings have broad implications for prostate cancer patients and management of biochemical recurrence.
Presented by: Maxwell Towe, Prostate Cancer, and Men's Health Fellow, University of California, Irvine, Department of Urology, Orange, United States
Written by: Linda My Huynh, a Senior Clinical Research Coordinator (Department of Urology, University of California-Irvine) and medical writer for UroToday.com. at the 34th European Association of Urology (EAU 2019) #EAU19 conference in Barcelona, Spain, March 15-19, 2019.