Oncological safety of testosterone replacement therapy in prostate cancer survivors after definitive local therapy: A systematic literature review and meta-analysis

Mehdi Kardoust Parizi, Mohammad Abufaraj, Harun Fajkovic, Shoji Kimura, Takehiro Iwata, David D'Andrea, Pierre I. Karakiewicz, Shahrokh F. Shariat

Research output: Contribution to journalReview article

2 Citations (Scopus)


Aim: To evaluate the association between testosterone replacement therapy (TRT) in prostate cancer (CaP) patients who underwent definitive local therapy with curative intent with biochemical recurrence (BCR). Materials and methods: A literature search using PubMed, Scopus, Web of Science, and Cochrane Library was conducted on November 2018 to identify relevant studies according to the Preferred Reporting Items for Systematic Review and Meta Analysis guidelines. The pooled BCR rate in CaP men treated with TRT after definitive local therapy with curative intent was calculated using a random effects model. Results: Twenty-one studies were eligible. The overall pooled BCR rate was 0.01 (95%CI 0.00–0.02) suggesting a lack of association between TRT and BCR; there was no heterogeneity among included studies (I2 = 24.34%, P = 0.15). In subgroup analyses, pooled BCR rates were 0.00 (95%CI 0.00–0.02) in patients treated with radical prostatectomy and 0.02 (95%CI 0.00–0.04) in patients treated with external beam radiation therapy, brachytherapy, cryotherapy, or high intensity focused ultrasound; there was no heterogeneity in the subgroup analyses (I2 = 19.88%, P = 0.18). Conclusions: In this systematic review and meta-analysis, we did not observe higher rate of BCR after TRT for nonmetastatic CaP patients after definitive local therapy. Based on these data, others and we have outlined a phase I/II trial assessing the safety and benefits of TRT in select men with secondary symptomatic hypogonadism who have no active disease after definitive local CaP therapy with curative intent.

Original languageEnglish
Pages (from-to)637-646
Number of pages10
JournalUrologic Oncology: Seminars and Original Investigations
Issue number10
Publication statusPublished - Oct 2019



  • Prostate cancer
  • Radiation therapy
  • Radical prostatectomy
  • Testosterone deficiency
  • Testosterone Replacement therapy

ASJC Scopus subject areas

  • Oncology
  • Urology

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