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Oncological Safety of Testosterone Replacement Therapy in Prostate Cancer Survivors After Definitive Local Therapy: A Systematic Literature Review and Meta-Analysis Publisher Pubmed



Kardoust Parizi M1, 2 ; Abufaraj M1, 3 ; Fajkovic H1, 4 ; Kimura S1, 5 ; Iwata T1, 6 ; Dandrea D1 ; Karakiewicz PI7, 8 ; Shariat SF1, 4, 9, 10, 11
Authors
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Authors Affiliations
  1. 1. Department of Urology, Medical University of Vienna, Vienna, Austria
  2. 2. Department of Urology, Shariati Hospital, Tehran University of Medical Sciences, Teheran, Iran
  3. 3. Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan
  4. 4. Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria
  5. 5. Department of Urology, Jikei University School of Medicine, Tokyo, Japan
  6. 6. Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
  7. 7. Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Quebec, Canada
  8. 8. Centre de recherche du Centre Hospitalier de l'Universite de Montreal (CR-CHUM) and Institut du cancer de Montreal, Montreal, Quebec, Canada
  9. 9. Department of Urology, Weill Cornell Medical College, New York, NY, United States
  10. 10. Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, United States
  11. 11. Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russian Federation

Source: Urologic Oncology: Seminars and Original Investigations Published:2019


Abstract

Aim: To evaluate the association between testosterone replacement therapy (TRT) in prostate cancer (CaP) patients who underwent definitive local therapy with curative intent with biochemical recurrence (BCR). Materials and methods: A literature search using PubMed, Scopus, Web of Science, and Cochrane Library was conducted on November 2018 to identify relevant studies according to the Preferred Reporting Items for Systematic Review and Meta Analysis guidelines. The pooled BCR rate in CaP men treated with TRT after definitive local therapy with curative intent was calculated using a random effects model. Results: Twenty-one studies were eligible. The overall pooled BCR rate was 0.01 (95%CI 0.00–0.02) suggesting a lack of association between TRT and BCR; there was no heterogeneity among included studies (I2 = 24.34%, P = 0.15). In subgroup analyses, pooled BCR rates were 0.00 (95%CI 0.00–0.02) in patients treated with radical prostatectomy and 0.02 (95%CI 0.00–0.04) in patients treated with external beam radiation therapy, brachytherapy, cryotherapy, or high intensity focused ultrasound; there was no heterogeneity in the subgroup analyses (I2 = 19.88%, P = 0.18). Conclusions: In this systematic review and meta-analysis, we did not observe higher rate of BCR after TRT for nonmetastatic CaP patients after definitive local therapy. Based on these data, others and we have outlined a phase I/II trial assessing the safety and benefits of TRT in select men with secondary symptomatic hypogonadism who have no active disease after definitive local CaP therapy with curative intent. © 2019 Elsevier Inc.
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