MP05-08 THE IMPACT OF BASELINE SERUM TESTOSTERONE ON THE RISK OF BIOCHEMICAL FAILURE AFTER DEFINITIVE RADIATION THERAPY FOR PROSTATE CANCER: MORE FAVOURABLE ONCOLOGICAL OUTCOMES IN HYPOGONADAL INVIDIDUALS

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Radiation Therapy I1 Apr 2017MP05-08 THE IMPACT OF BASELINE SERUM TESTOSTERONE ON THE RISK OF BIOCHEMICAL FAILURE AFTER DEFINITIVE RADIATION THERAPY FOR PROSTATE CANCER: MORE FAVOURABLE ONCOLOGICAL OUTCOMES IN HYPOGONADAL INVIDIDUALS Emanuele Zaffuto, Pierre I. Karakiewicz, Helen Davis Bondarenko, Sami-Ramzi Leyh-Bannurah, Guila Delouya, Carole Lambert, Jean-Paul Bahary, Marie Claude Beauchemin, Maroie Barkati, Cynthia Ménard, Markus Graefen, Alberto Briganti, Fred Saad, and Daniel Taussky Emanuele ZaffutoEmanuele Zaffuto More articles by this author , Pierre I. KarakiewiczPierre I. Karakiewicz More articles by this author , Helen Davis BondarenkoHelen Davis Bondarenko More articles by this author , Sami-Ramzi Leyh-BannurahSami-Ramzi Leyh-Bannurah More articles by this author , Guila DelouyaGuila Delouya More articles by this author , Carole LambertCarole Lambert More articles by this author , Jean-Paul BaharyJean-Paul Bahary More articles by this author , Marie Claude BeaucheminMarie Claude Beauchemin More articles by this author , Maroie BarkatiMaroie Barkati More articles by this author , Cynthia MénardCynthia Ménard More articles by this author , Markus GraefenMarkus Graefen More articles by this author , Alberto BrigantiAlberto Briganti More articles by this author , Fred SaadFred Saad More articles by this author , and Daniel TausskyDaniel Taussky More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.167AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The exact role of pre-treatment (baseline) total serum testosterone (BST) is still controversial in patients with prostate cancer (PCa) and conflicting results are reported in the literature. We assessed the impact of BST on the risk of biochemical failure (BF) in patients with PCa and treated with definitive radiation therapy (RT). METHODS The current study is a retrospective analysis of 360 prospective patients diagnosed with non-metastatic PCa between 2002 and 2014 and enrolled into seven different prospective multicentric phase II-III trials performed at our institution. All patients received definitive RT after initial diagnostic workup which included PSA and BST assessment. Patients were stratified according to hypogonadal (BST<11 nmol/L) vs. non-hypogonadal state (BST≥11 nmol/L). The ability of this BST cut-off to predict BF was assessed in Kaplan-Meier analyses, as well as in univariable and multivariable Cox regression analyses. Internal validation of our findings was performed using bootstrap resampling with 10,000 replications. RESULTS The median (IQR) age at diagnosis was 71 years (65-74). Median (IQR) PSA was 7.7 ng/mL (5.6-12.1). Testosterone ranged from 0.7 to 28.9 nmol/L (mean: 11 nmol/L; median 10.2 nmol/L; IQR 8.3-13.0 nmol/L). The number of patients with BST < 11 nmol/L was 209 (58.0%), while a total of 151 patients had a BST ≥ 11 nmol/L (42.0%). A total of 272 patients (75.6%) had available BMI data, which ranged between 17.5 and 52.6, without significant differences between the two groups (p=0.1). ADT was administered only to 108 patients (30%), including all individuals diagnosed with PSA > 20 ng/mL. Median follow-up was 72 months. Overall, BF-free survival rates at 96 months was 79.6% (95% CI: 72.3-87.6%) in hypogonadal vs. 65.1% (95% CI: 55.3-76.7%) in non-hypogonadal individuals (p=0.042). In multivariable Cox regression analyses, BST < 11 nmol/L was associated with a significantly reduced risk of BF (HR: 0.50; CI 0.30-0.83; p = 0.007). After 10,000 bootstrap resamples, virtually the same results were recorded. CONCLUSIONS Oncologic outcomes for PCa after primary radiation therapy are affected by pre-treatment testosterone levels. Individuals with lower baseline testosterone levels experienced more favourable biochemical failure rates after adjusting for the use of ADT. As many still debate about the role of testosterone in PCa, our findings need to be validated in larger patient cohorts. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e40-e41 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Emanuele Zaffuto More articles by this author Pierre I. Karakiewicz More articles by this author Helen Davis Bondarenko More articles by this author Sami-Ramzi Leyh-Bannurah More articles by this author Guila Delouya More articles by this author Carole Lambert More articles by this author Jean-Paul Bahary More articles by this author Marie Claude Beauchemin More articles by this author Maroie Barkati More articles by this author Cynthia Ménard More articles by this author Markus Graefen More articles by this author Alberto Briganti More articles by this author Fred Saad More articles by this author Daniel Taussky More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...