USA: Testosterone therapy(TT) is safe after definitive treatment of localized prostate cancer in appropriate patients, suggests a recent study in the journal Prostate Cancer and Prostatic Diseases. According to the study, after surgery or radiation, TT did not increase the risks of prostate-cancer specific or overall mortality and biochemical recurrence.
Reith R. Sarkar, University of California San Diego, La Jolla, CA, USA, and colleagues analyzed the risks of biochemical recurrence and mortality in men receiving TT after treatment for localized prostate cancer.
Cohort analysis was conducted using the US Veterans Affairs Informatics and Computing Infrastructure. The researchers identified 69,984 patients having localized prostate cancer and were treated with radiation or surgery. Receipt of TT was coded after treatment as a time-dependent covariate. The National Death Index fused to identify the cause of death and defined biochemical recurrence as PSA > 0.2 ng/mL after surgery and nadir + 2 ng/mL after radiation. Using cumulative incidence curves, Fine–Gray competing risk regression, and Cox regression, the researchers analyzed recurrence and mortality.
This cohort included 28,651 surgery patients and 41,333 radiation patients, of whom 469 (1.64%) and 543 (1.31%), respectively, received TT with a median follow-up of 6.95 years.
Key findings of the study include:
Comparing testosterone users to nonusers, there were no between-group differences in biochemical recurrence, prostate cancer-specific mortality, or overall mortality after surgery [hazard ratios (HR): 1.07; HR: 0.72 and HR: 1.11 respectively] or radiation [HR: 1.07; HR: 1.02; and HR: 1.02, respectively.
Limitations included lack of detailed data on TT duration and serum testosterone concentrations.
"In this multi-ethnic national cohort, TT did not increase the risks of biochemical recurrence or prostate cancer-specific or overall mortality after surgery or radiation. These data suggest that TT is safe in appropriate men after definitive treatment of localized prostate cancer," concluded the authors.
The study, "Testosterone therapy does not increase the risks of prostate cancer recurrence or death after definitive treatment for localized disease," is published in the journal Prostate Cancer and Prostatic Diseases.
DOI: https://doi.org/10.1038/s41391-020-0241-3