Introduction: We aimed to evaluate the impact of testosterone replacement therapy (TRT) in patients with localized prostate cancer who elected active surveillance (AS). Methods: A retrospective review of our AS database was performed. Patients who received TRT while on AS were identified. A cohort of patients who underwent AS while not on TRT was matched in a ratio of 1:2. Both groups were compared. Kaplan Meier analysis and log-rank test were performed to compare treatment-free survival. Statistical significance was defined as p = 0.05. Results: 23 (2%) patients who underwent TRT while on AS were identified. Two patients elected discontinuation of TRT and 2 were lost to follow up. Median follow-up was 91 months. Nineteen patients in the TRT group were matched to 40 patients without TRT. There was no significant difference in conversion to treatment (21% vs 22%, p=1.00), time to conversion to treatment (56 vs 42 months, p=0.09) or the change in PSA while on AS (-0.05 vs 1.45, p=0.56) (Table 1). Kaplan Meier analysis showed no significant difference in treatment-free survival between the 2 groups (log rank p>0.05) (Figure 1). Univariate analysis showed that Age, CCI, receipt of TRT, Gleason grade at initiation of AS or history of fusion biopsy were not associated with conversion to treatment. Conclusions: TRT was not associated with conversion to treatment in this matched analysis among patients with localized prostate cancer on AS. Despite limitations, to our knowledge, this study has the longest follow-up in patients receiving TRT while on AS. SOURCE OF Funding: None
