Testosterone Recovery Linked to Overall Survival in High-Risk Prostate Cancer

TUESDAY, Feb. 18, 2025 (HealthDay News) — Serum testosterone (T) recovery to normal levels is associated with a significant improvement in overall survival in patients with high-risk prostate cancer receiving radiotherapy and long-term androgen deprivation therapy (ADT), according to a study presented at the American Society of Clinical Oncology annual Genitourinary Cancers Symposium, held from Feb. 13 to 15 in San Francisco.

Abdenour Nabid, M.D., from Centre Hospitalier Universitaire de Sherbrooke in Quebec, Canada, and colleagues randomly assigned 630 patients with high-risk prostate cancer to pelvic radiotherapy plus 36 versus 18 months of ADT (310 and 320 patients, respectively). Serum T was collected at baseline and regularly thereafter. T recovery was defined as return of T to within the normal range value of each participating institution. T data were available for 515 patients who were retained for the analysis.

Overall, 6,587 T measurements were available during a period of 22 years (median follow-up, 17.4 years). The researchers found that 52.4 percent of patients recovered T to normal levels: 57.0 and 44.3 percent in the 18- and 36-month cohorts, respectively. Patients not recovering T to a normal level were older, had higher clinical stage, and had diabetes. The median time to T recovery was 3.6 years among patients regaining T to a normal level. The 10- and 15-year overall survival rates were 76 and 44 percent, respectively, among those recovering T versus 55 and 30 percent, respectively, for those not recovering T. When considering the global hazard ratio, a significantly lower risk for death favored patients recovering T (hazard ratio, 0.54).

“The increased death rate in patients not recovering T is likely due to causes unrelated to prostate cancer,” the authors write.

Several authors disclosed ties to the pharmaceutical industry.

Abstract

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