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KMID : 1011820180590010018
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Investigative and Clinical Urology
2018 Volume.59 No. 1 p.18 ~ p.24
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Factors associated with testosterone recovery after androgen deprivation therapy in patients with prostate cancer
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Nam Wook
Choi Se-Young
Yoo Sang-Jun
Ryu Je-Man
Lee Jae-Hoon
Kyung Yoon-Soo
Han Jae-Hyeon
You Dal-San
Jeong In-Gab
Hong Jun-Hyuk
Ahn Han-Jong
Kim Choung-Soo
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Abstract
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Purpose: We investigated factors affecting testosterone recovery after androgen deprivation therapy (ADT) withdrawal in patients with prostate cancer.
Materials and Methods: The medical records of patients who underwent radical prostatectomy with ADT were retrospectively reviewed. In all, 221 patients were included in the analysis. Testosterone recovery was defined as supra-castration (SC) (testosterone levels in serum >50 ng/dL) or out of hypogonadism (OH) (>300 ng/dL) after ADT withdrawal. Kaplan-Meier analyses were used to estimate testosterone recovery after ADT cessation. Cox regression analyses were used to determine the factors affecting the recovery of testosterone.
Results: After ADT, 206 patients (93.2%) recovered to the SC level and 122 patients (55.2%) recovered to the OH level. Patients treated with ADT for ≤18 months recovered to OH in a mean of 6.8 months (74.6%), but patients treated with ADT for >18 months recovered in a mean of 9.7 months (27.5%). In multivariate analyses, age (hazard ratio [HR], 0.915; p<0.001), serum level of sex hormone-binding globulin (SHBG) (HR, 1.015; p=0.002), initial testosterone level (HR, 1.002; p=0.002), and ADT duration (HR, 0.915; p<0.001) were associated with recovery to the OH level after ADT withdrawal, and hypertension (HR, 0.697; p=0.029) and duration of ADT (HR, 0.979; p=0.012) were significantly associated with recovery to SC.
Conclusions: In patients treated with ADT for ≤18 months, testosterone recovers to the OH level more often and faster after ADT cessation. Age, SHBG level, initial testosterone level, and ADT duration are associated with testosterone recovery.
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KEYWORD
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Androgen deprivation therapy, Prostatic neoplasms, Testosterone
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