Testosterone replacement therapy in men on active surveillance for prostate cancer.

TRT significantly increased testosterone levels in men on active surveillance for prostate cancer.

• 43 men met the inclusion criteria in this retrospective single-center analysis.
• Median (IQR) testosterone level before therapy was 272 (221.5–333.5) ng/dL.
• Median (IQR) testosterone level after therapy was 578.5 (354.5–846.5) ng/dL.
• The increase in testosterone levels was statistically significant (P < 0.01).

TRT did not result in statistically significant changes in mean PSA levels in men on active surveillance.

• No significant variation in mean PSA levels was observed (P = 0.87).
• PSA and testosterone levels were recorded at regular intervals one year before and after the initiation of testosterone.
• ANOVA was used to analyze variance in PSA and testosterone levels, along with paired t-tests and linear regression analysis.

The majority of patients who underwent surveillance biopsies after starting TRT showed no disease progression.

• Baseline biopsies were available for 27 patients, showing Gleason 3+3=6 in no more than three cores.
• 15 (55.6%) patients had one or more surveillance biopsies after starting testosterone therapy.
• Of these, 12 (80.0%) had no disease progression in biopsies over a mean of 44.3 months on testosterone.
• Three patients (20.0%) had a Gleason score 7 on biopsy after a mean of 79.5 months on testosterone therapy.
• No patients developed metastatic disease.

The study population consisted of men with hypogonadism who were on active surveillance for low-risk prostate cancer.

• Men previously treated for prostate cancer were excluded from the analysis.
• Baseline biopsies for 27 patients showed Gleason 3+3=6 in no more than three cores, consistent with low-risk disease.
• The study was a retrospective single-center analysis with a longitudinal follow-up design.
• Limitations include the retrospective design, small sample size, and lack of a control group.

The rate of biopsy progression observed in this cohort appeared comparable to that reported in the general active surveillance population.

• 20.0% (3 of 15) of patients with surveillance biopsies showed Gleason score upgrading to 7 after a mean of 79.5 months on testosterone therapy.
• The authors noted that 'findings suggest similar rates of disease progression compared to the general AS population.'
• Pathology changes were described as 'inconclusive' due to limited biopsy data availability.