PURPOSE Testosterone (T) therapy (TTh) in men with T deficiency who have undergone radical prostatectomy (RP) for prostate cancer remains controversial. We aimed to assess the impact of TTh on biochemical recurrence (BCR) rates after RP in men with low-intermediate organ-confined disease. MATERIALS AND METHODS This study included men who underwent an RP at our institution for organ-confined prostate cancer and had grade groups 1 to 3 on RP pathology. A Cox model was created for time to BCR with T use included as a time-dependent covariate, adjusted for age, preoperative PSA, grade group at RP, and the presence of comorbidities. A landmark analysis was used: Patients were included in the analysis if their last PSA in the 18 weeks postoperatively was undetectable and they had not had BCR or been lost to follow-up by that point, and follow-up for BCR began at 18 weeks. BCR was defined as a PSA ≥ 0.1 ng/mL after RP with a second confirmatory rise ≥ 0.1 ng/mL. RESULTS The study population included 5199 men after RP, with 198 patients receiving T at any point after RP and 5001 not receiving T. The median age was 59 (interquartile range, 55-65) and 61 (interquartile range, 56-66) years, respectively. Men in the T group tended to present with more vascular comorbidities. For those receiving T, clomiphene citrate was prescribed in 49% of men, 32% received transdermal T, and 19% intramuscular T. We found a nonsignificantly decreased risk of BCR associated with the use of T after RP (hazard ratio, 0.84; 95% CI, 0.48-1.46; P = .5), and overall rates of BCR were low, with probability of BCR at 5 years less than 2% in both groups. CONCLUSIONS TTh can be given to select men after RP. We found no evidence that administration of TTh after RP causes BCR.

中文翻译：

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男性根治性前列腺切除术后中低器官限制性前列腺癌的睾酮治疗。


目的 因前列腺癌接受根治性前列腺切除术 （RP） 的 T 缺乏男性的睾酮 （T） 疗法 （TTh） 仍然存在争议。我们旨在评估 TTh 对中低器官局限性疾病男性 RP 后生化复发 （BCR） 率的影响。材料和方法 本研究包括在我们机构接受器官局限型前列腺癌 RP 且 RP 病理学等级为 1 至 3 级的男性。为 BCR 时间创建了一个 Cox 模型，其中 T 使用作为时间依赖性协变量，根据年龄、术前 PSA、RP 分级组和合并症的存在进行调整。使用了一项具有里程碑意义的分析：如果患者在术后 18 周内的最后一次 PSA 检测不到并且此时他们没有 BCR 或失访，并且 BCR 的随访从 18 周开始，则将其纳入分析。BCR 定义为 RP 后 PSA ≥ 0.1 ng/mL，第二次确认升高≥ 0.1 ng/mL。结果研究人群包括 5199 名 RP 后男性，其中 198 名患者在 RP 后的任何时间点接受 T，5001 名患者未接受 T。中位年龄分别为 59 岁 （四分位距，55-65） 和 61 （四分位距，56-66） 岁。T 组男性往往表现为更多的血管合并症。对于接受 T 的患者，49% 的男性使用克罗米芬柠檬酸盐，32% 接受透皮 T，19% 接受肌内注射 T。我们发现 RP 后使用 T 相关的 BCR 风险未显著降低（风险比，0.84;95% CI，0.48-1.46;P = .5），总体 BCR 发生率较低，两组 5 年 BCR 的可能性均小于 2%。结论 RP 后可给予 TTh 选择男性。我们没有发现 RP 后给予 TTh 导致 BCR 的证据。