Impact and Outcomes of Pretreatment Total Serum Testosterone on Localized Prostate Cancer Patients

Purpose. To investigate how pretreatment testosterone levels correlate with progression-free survival, metastasis-free survival, and overall survival in a propensity-adjusted localized prostate cancer population. Methods. Men diagnosed with clinical NCCN-risk stratified very-low, low, intermediate, high, and/or very-high risk prostate cancer who had a baseline total serum testosterone level≥100？ng/dl measured within the 100？days preceding the first definitive therapy were identified from our prospectively gathered institutional database. Cohorts below (100–239？ng/dl), within (240–593？ng/dl), or above (594？+？ng/dl) one standard deviation from the mean testosterone level (416？ng/dl) were used for comparison. Progression-free, metastasis-free, and overall survival were evaluated. A separate cohort of men not receiving ADT was used to evaluate testosterone recovery after various treatment modalities (surgery, external beam radiation, brachytherapy, or combined EBRT？+？Brachy). Results. There was no statistically significant difference between the low, average, and high testosterone cohorts for PFS, MFS, or OS. In men not using ADT, there were no statistically significant changes in testosterone levels 1 year after therapy, regardless of therapy type. Conclusion. In men with serum testosterone levels >=100？ng/dl at diagnosis, baseline testosterone does not impact PFS, MFS, or OS. Recovery of testosterone back to baseline is expected for men undergoing either surgery, external beam or brachytherapy, or combined modality radiation when not using ADT