You have accessJournal of UrologySexual Function/Dysfunction/Andrology: Medical and Non-Surgical Therapy1 Apr 20121488 TESTOSTERONE REPLACEMENT THERAPY IN PATIENTS WITH HIGH RISK PROSTATE CANCER AFTER RADICAL PROSTATECTOMY LONG-TERM FOLLOW-UP Alexander W. Pastuszak, Amy M. Pearlman, Kumaran Sathyamoorthy, Joceline S. Liu, Larry I. Lipshultz, Brian J. Miles, and Mohit Khera Alexander W. PastuszakAlexander W. Pastuszak Houston, TX More articles by this author , Amy M. PearlmanAmy M. Pearlman Houston, TX More articles by this author , Kumaran SathyamoorthyKumaran Sathyamoorthy Houston, TX More articles by this author , Joceline S. LiuJoceline S. Liu Chicago, IL More articles by this author , Larry I. LipshultzLarry I. Lipshultz Houston, TX More articles by this author , Brian J. MilesBrian J. Miles Houston, TX More articles by this author , and Mohit KheraMohit Khera Houston, TX More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2010AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Testosterone (T) replacement therapy (TRT) in the setting of prostate cancer (CaP), particularly CaP bearing high-risk characteristics, is controversial, with concern that exogenous T can stimulate CaP recurrence or progression. However, data supporting efficacy of TRT in the absence of progression of CaP continue to accrue. Here we present our follow-up experience with safety and efficacy of TRT in men who have undergone radical prostatectomy in a cohort of men bearing high-risk CaP characteristics. METHODS A retrospective review of 92 men with hypogonadism treated with TRT after radical prostatectomy for CaP between 2007-2011 was performed. Sixty-four men with CaP bearing low/intermediate risk characteristics (non-high risk) and 28 with CaP bearing high-risk characteristics (at least one of the following: 1) Gleason score ≥8, 2) positive surgical margins, or 3) positive lymph nodes) were included. Serum T, free T (FT), prostate specific antigen (PSA), hemoglobin (Hgb), and hematocrit (Hct) were assessed at TRT initiation and every 3-6 months thereafter out to >36 months. Biopsy and final pathologic Gleason (Gl) scores, surgical margins were also evaluated. RESULTS Mean±SD age was 62±7.6years, initial T 288.6±121.1ng/dL, PSA 0.004±0.003ng/ml, Hgb 14.74±1.50g/dL, and Hct 44.02±4.12%. Initial Gleason sums for high and non-high risk groups were 6.81±1.11 and 6.42±0.64 (p=0.152), and the high components of the Gleason score were 3.62±0.74 and 3.44±0.55 (p=0.282) for each group, respectively. Median follow-up was 22.5 months (range 1-49.5 months) at which time significant increases in mean T and free T were observed in both high and non-high risk groups. Mean increases in Hgb of 1.46 g/dL (high risk, p=0.17) and 0.79 g/dL (non-high risk, p=0.03) were observed. A significant rise in PSA was observed in the high-risk group at median follow-up (0.004±0.003 to 0.014±0.019ng/mL, p=0.017) but not in the non-high risk. The mean PSA velocities (PSAV) for the high and non-high risk groups were 0.0080±0.0107 ng/mL/yr and 0.0013±0.0031 ng/mL/yr, respectively (p=0.008). No PSA recurrences were observed. Final pathologic diagnosis resulted in upgrading of 29% of patients, and downgrading of 11% of patients. CONCLUSIONS TRT remains a viable treatment alternative in men with a history of CaP who have undergone prostatectomy, even those with CaP bearing high risk characteristics, with recurrence rates in our series below those published in other series of comparably matched men not treated with TRT. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e603 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alexander W. Pastuszak Houston, TX More articles by this author Amy M. Pearlman Houston, TX More articles by this author Kumaran Sathyamoorthy Houston, TX More articles by this author Joceline S. Liu Chicago, IL More articles by this author Larry I. Lipshultz Houston, TX More articles by this author Brian J. Miles Houston, TX More articles by this author Mohit Khera Houston, TX More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...