Taira AV, et al. - Researchers investigated the impact of androgen deprivation therapy (ADT) on overall mortality (OM) in prostate brachytherapy patients with lower pretreatment serum testosterone levels vs normal or high baseline serum testosterone. They found that ADT use may result in an increased risk of premature death in men with lower baseline testosterone vs men with baseline normal or higher testosterone.

Methods

• This study included 1,916 patients who had brachytherapy between October 2001 and May 2014 and had a pretreatment serum testosterone.
• Prior to therapy initiation, baseline serum testosterone values were collected prospectively and participants were followed-up over a median of 7.2 years.
• ADT was received by 26% of the patients, primarily men with higher risk disease.
• Researchers assessed OM and prostate cancer-specific mortality to see if men with lower baseline serum testosterone were at increased risk of mortality when ADT was used, vs men with baseline normal or higher testosterone.

Results

• At 10 years, observed prostate cancer-specific mortality was 0.8% and OM was 22.0%.
• The identified strongest predictors of OM included age, tobacco use, diabetes, cardiovascular disease, and percent positive biopsies.
• They found that ADT use by itself was not related to an increased risk of OM on multivariate analysis (P=0.695).
• However, findings revealed that ADT use in men with lower baseline testosterone was related to a significantly higher risk of OM (P < 0.01), while ADT use in men with normal or higher baseline testosterone was not related to an increased OM risk (P=0.924).