Baseline endogenous serum testosterone levels and all-cause mortality in men with prostate cancer treated by radical radiotherapy: 11-year follow-up data.

person Santhanam Sundar Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom info_outline Santhanam Sundar, Ewan Shawcroft, Lauren Jones, Micheal O'Cathail, Shaymaa Usama Hosni, Jessica Little, Georgina Walker, Ashley Cox, Eamonn Fergusson

Authors person Santhanam Sundar Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom info_outline Santhanam Sundar, Ewan Shawcroft, Lauren Jones, Micheal O'Cathail, Shaymaa Usama Hosni, Jessica Little, Georgina Walker, Ashley Cox, Eamonn Fergusson Organizations Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom, Nottingham University Hospitals NHS trust, Nottingham, United Kingdom, St Bartholomew's Hospital, London, United Kingdom, Nottingham University Hospital NHS Trust, Nottingham, United Kingdom, Royal United Hospitals Bath NHS Foundation Trust, Bath, United Kingdom, University of Nottingham, Nottingham, United Kingdom Abstract Disclosures Research Funding No funding received None. Background: Low levels of serum testosterone are associated with higher all-cause mortality and cardiovascular mortality in some studies .(PMID: 18040028). But men with low levels of serum testosterone at reduced risk of developing prostate cancer. (PMID: 30077399). In middle-aged and elderly men, single point testosterone measurements have been shown to reliably reflect long term androgen exposure. [PMID: 1548361]. We assessed the interaction of pre-treatment serum testosterone levels and long term all-cause mortality in men with newly diagnosed prostate cancer. Methods: Prostate cancer pts enrolled in an ethics approved, prospective study evaluating a rating scale. Baseline serum testosterone levels were measured before the pts were commenced on androgen deprivation therapy and radical radiotherapy. Patient characteristics: Mean age 68.2yrs (median 69yrs); Age range category < 60yrs:14.9% , 61-70yrs:47.3% and > 71 yrs: 37.8%. Charlson Comorbidity Index (CCI) prevalence at baseline as follows CCI- Low risk : 39.9%; CCI-medium risk : 51.4%; CCI-high risk: 8.8%. PSA median level was 10.85 ug/L. Tumour was localised in a majority of pts- stage T1/T2 in 72% . Pts with M1 disease were not enrolled. Histology grade: Gleeson grade 6 in 7.4% and Gleeson grade 7 in 53.4% . Serum testosterone: Median 11.9 nmol/l; Mean 12.4 (Min-Max 2.6 to 26.7). Cox proportional hazards regression used to analyze the effect of baseline Serum Testosterone on long term overall survival, while controlling for covariates (age, cancer T stage, PSA category, Gleeson Category and Charlson Comorbidity index). Results: Lower levels of serum testosterone at baseline were associated with decreased all-cause mortality. There was no significant correlation between testosterone levels and age in our study sample of relatively elderly population (Pearson Correlation p = 0.362); There was no correlation testosterone levels and PSA levels(P = 0.821); no association between serum Testosterone levels and Gleeson Grade as well as T stage. (F = 0.78 ; P = 0.46 and F = 1.34 ; P = 0.26 respectively). There was also no significant variation in testosterone levels according to Comorbidity categorised by Charlson Comorbidity Index. (F = 1.31 P = 0 .26). Conclusions: Lower Serum testosterone levels were associated with decreased all-cause mortality in this prospectively collected survival data of non-metastatic Prostate cancer patients. SPSS delineated quartiles for Baseline Serum Teststerone Median testosterone (nmol/l) P values Cox regression Exp(B) with 95.0% CI for Exp(B) 1 st quartile (upto 8.9) n = 30 7.3 4 th vs 1 st Quartile .012 Exp(B) 0.362 (0.163, 0.802) 2 nd quartile (8.9 to 11.9) n = 37 10.6 4 th vs 2nd Quartile .037 Exp(B) 0.485 (0.245, 0.959) 3 rd quartile (11.9-15.6) n = 33 13.6 4 th vs 3rd Quartile .068 Exp(B) 0.509 (0.247, 1.052) 4 th quartile ( = > 15.6) n = 31 18 Reference