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

Testosterone Replacement Therapy in Men with Untreated or Treated Prostate Cancer: Do We Have Enough Evidences?

“…After careful review of the full articles, 89 articles were excluded for the following reasons: 37 were review articles, 12 were letters to the editor, 12 were out of scope, 15 covered the relevant subject but failed to satisfy the inclusion criteria in detailed methodology, 2 lacked eligibility data, and 11 studies were excluded owing to duplication of population. Eventually, 36 studies were selected for the narrative systematic review [ 7 8 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 ]. Among them, four studies had a double-armed design [ 52 54 56 60 ]; quantitative synthesis was performed using these studies to assess the risk of prostate cancer progression in patients receiving TRT.…”

“…Of the 36 included studies, two were single-armed prospective studies [ 43 44 ], four were double-armed retrospective studies [ 52 54 56 60 ], and the remaining studies had single-armed retrospective features (case series or case reports) [ 7 8 29 30 31 32 33 34 35 36 37 38 39 40 41 42 45 46 47 48 49 50 51 53 55 57 58 59 61 62 ]. Patients underwent active surveillance in 5 of the 36 studies [ 42 48 49 57 60 ], radical prostatectomy in 11 studies [ 7 33 38 39 40 45 47 50 52 55 56 ], radiation therapy in 5 studies [ 35 41 51 53 59 ], multiple intervention modalities in 6 studies [ 36 46 54 58 61 62 ], and systemic therapy in 9 studies [ 8 29 30 31 32 34 37 43 44 ], for the management of underlying prostate cancer. Except for some old studies conducted in the pre-PSA era [ …”

“…Patients underwent active surveillance in 5 of the 36 studies [ 42 48 49 57 60 ], radical prostatectomy in 11 studies [ 7 33 38 39 40 45 47 50 52 55 56 ], radiation therapy in 5 studies [ 35 41 51 53 59 ], multiple intervention modalities in 6 studies [ 36 46 54 58 61 62 ], and systemic therapy in 9 studies [ 8 29 30 31 32 34 37 43 44 ], for the management of underlying prostate cancer. Except for some old studies conducted in the pre-PSA era [ 8 29 30 31 32 ], a database study [ 54 ], and a study with active surveillance [ 57 ], almost all studies utilized PSA as an oncologic outcome parameter [ 7 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 55 56 58 59 60 61 62 ]. As almost all included studies had single-armed retrospective feature, the quality scores measured by the MIN...…”

“…Evidences for effects of TRT in patients with radical prostatectomy comprised 15 studies, which included a total of 697 TRT-treated patients and 103 TRT-untreated controls ( Table 2 ) [ 7 33 36 38 39 40 45 47 50 52 55 56 58 61 62 ]. All the included 15 studies implied that TRT might be harmless in patients with radical prostatectomy (progression rate: 0.0%–6.5% during 8–52 months of follow-up; Table 2 ).…”

“…Effects of TRT in patients with local definitive treatments such as radical prostatectomy or radiation therapy were re-assessed according to the disease risk ( Table 3 ). Evidences for effects of TRT in patients with low-risk disease undergoing local treatment comprised 15 studies, which included a total of 315 TRT-treated patients and 89 TRT-untreated controls ( Table 3 ) [ 7 33 35 38 39 40 41 51 52 53 55 56 58 59 61 ]. All the included 15 studies implied that TRT might be harmless for low-risk patients (progression rate: 0.0%–1.8% during 6–60 months of follow-up; Table 3 ).…”