Biopsy Gleason score and the duration of testosterone suppression among men treated with external beam radiation and 6 months of combined androgen blockade
BJU International, 05/07/2012Martin NE et al.
A biopsy Gleason score of 8–10 was associated with a shorter period of testosterone suppression following 6 months of combined androgen blockade and radiation therapy. These data are consistent with the hypothesis that a factor released from high–grade prostate cancer cells may impact on testosterone production.
The study cohort consisted of 221 men with PCa treated with RT and 6 months of CAB between 1996 and 2005.
The authors defined the duration of testosterone suppression as the time between the last day of CAB and the date the testosterone returned to ≥ 252 ng/dL.
They used Cox regression multivariable analysis to relate biopsy Gleason score to duration of testosterone suppression following cessation of CAB.
A biopsy Gleason score of 8-10 had an adjusted hazard ratio (AHR) of 1.56 (95% confidence interval [CI] 1.04, 2.34; P= 0.03) for a shorter time to testosterone normalization relative to Gleason 6.
Specifically, the 51 men with biopsy Gleason score of 8–10 had a median time to testosterone normalization of 17.0 months compared with 22.1 months and 23.8 months for those with biopsy Gleason ≤ 6 and 7, respectively.
Increasing age was significantly associated with a longer duration of testosterone suppression (AHR of 0.95 [95% CI 0.92, 0.97; P < 0.001]) as was a higher baseline PSA (AHR 0.82 [95% CI 0.69, 0.97; P= 0.02]).
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