Androgen replacement therapy in patients with age-related hypogonadism after radical retropubic prostatectomy for localized prostate cancer

Abstract 

Background

The aim was to estimate the efficacy and safety of androgen replacement therapy (ART) in a retrospective cohort study of a group of patients with signs and symptoms of hypogonadism who had undergone radical retropubic prostatectomy (RRP) for localized prostate cancer (PCa).

Methods

The results of treatment in 16 patients who had undergone RRP for localized PCa at stage pT2N0M0 during the years 2001–2005 were analyzed. Both prior to and following the ART, serum total testosterone (T), and prostate-specific antigen (PSA) levels were evaluated, and signs and symptoms were assessed using the Aging Male Symptoms (AMS) Scale.

Results

With a mean ART duration of 15 months, the mean test level increased from 6.5±1.98nmol/l to 19.2±5.1nmol/l (from 188±57ng/dl to 555±198ng/dl) (p<0.01), while the AMS symptom score decreased from 40.4±5.4 to 20.8±3.8 points. None of the patients had evidence indicative of biochemical or clinical progression of localized PCa.

Conclusion

Our experience of the treatment of 16 patients and the relevant literature data suggest that in the carefully selected patients with the signs and symptoms of hypogonadism following RRP, the safe use of ART with a good clinical effect is feasible. To formulate the clinical guidelines on ART in patients who have been surgically cured of PCa, prospective, multicenter studies with large numbers of patients are required.

Keywords: Testosterone, Hypogonadism, Prostate, Prostatic neoplasms, Prostatectomy