(062) THE RISK OF BIOCHEMICAL RECURRENCE OF PROSTATE CANCER IN MEN RECEIVING TESTOSTERONE REPLACEMENT THERAPY FOLLOWING RADICAL PROSTATECTOMY

Abstract Introduction Modern evidence and new theoretical frameworks have significantly challenged long-held beliefs about androgens and Prostate Cancer (PCa). However, there remain substantial controversies, especially concerning the use of testosterone therapy (TTh) in men with any history of PCa. Objective Analyze the risk of biochemical recurrence (BCR) of PCa in men who received TTh compared to men who did not receive TTh following radical RP. Methods Patients who underwent an RP from 2013-2023 with total testosterone (TT) and PSA levels were included. The risk groups were defined as the following: PSA <10 and grade group 1 (Gleason 6) as Low Risk; PSA is between 10 and 20, or grade group 2 or 3 (Gleason 7) as Intermediate Risk; PSA >20, or grade group 4 or 5 (Gleason 8 to 10), including T3b or T4 pathology as High Risk. BCR is defined as PSA > 0.2. Low testosterone (T) was described as a total T (TT) level < 300 ng/dL on two occasions using LCMS collected before noon. Men were grouped based on risk groups, and T levels and TTh use were recorded. Men were divided into TT >300 and no TTh (NT); TT <300, who did not receive TTh (LT-); TT <300, who received TTh (LT+); TT >300, who received TTh (NT+). Rates and time to BCR were recorded. Chi-square analysis and Fisher’s Exact test were performed for group comparisons. Kruskal Wallis Test was used to compare medians with log-rank (mantel-cox) significance reported. Kaplan Meier survival analysis was performed for time to BCR and time to follow-up. For all statistical analyses, clinical significance was assessed at p < 0.05. Individuals with missing values were not included in the analyses. All statistical analysis was conducted using SPSS. Results 1105 men, with a median age of 63, were included. 1.6% had low risk (LR), 41.6% intermediate risk (IR), and 56.8% had high risk (HR) PCa. The median follow-up time was 50 months, and the median to BCR was ten months. 42% of patients were NT, 50.7% LT-, 3.4% LT+, and 3.9% were NT+. There was a significant difference in BCR rates between NT, LT-, LT+, and NT+ within the intermediate and high-risk groups (p < 0.001), with the HR PCa group having the highest BCR rate (46.9%). Within the HR PCa men, the LT- group had the highest BCR rate (61.5%) compared to the HR NT+, which had the lowest BCR at 20%. Lastly, LT- group had the lowest median time to recurrence (4 months) compared to LT+ which had the longest (51 months). (p = 0.020). (Figure 1). Conclusions TTh in men with PC does not increase rates of or time to BCR. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast; Boston Scientific; BK Ultrasound.