{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T19:12:12Z","timestamp":1760296332514,"version":"build-2065373602"},"reference-count":30,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2017,12,20]],"date-time":"2017-12-20T00:00:00Z","timestamp":1513728000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Low testosterone at the time of diagnosis of prostate cancer has been associated with a worse prognosis. Whether this is true and how to define the best treatment approach at the time of first prostate\u2010specific antigen (PSA) failure to the authors' knowledge has not been elucidated to date and was studied herein.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Between 1995 and 2001, a total of 58 men with unfavorable\u2010risk PC who were treated on clinical trials with radiotherapy and androgen deprivation therapy (ADT) had available testosterone levels at the time of PSA failure. Cox and Fine and Gray regressions were performed to ascertain whether low versus normal testosterone was associated with the risk of PC\u2010specific mortality, other\u2010cause mortality, and all\u2010cause mortality adjusting for age, salvage ADT, and known PC prognostic factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>After a median follow\u2010up of 6.68 years after PSA failure, 31 men (53.4%) had died; 10 of PC (32.3%), of which 8 of 11 (72.7%) versus 2 of 47 (4.3%) deaths occurred in men with low versus normal testosterone at the time of PSA failure, respectively. A significant increase in the risk of all\u2010cause mortality (adjusted hazard ratio [AHR], 2.54; 95% confidence interval [95% CI], 1.04\u20106.21 [<jats:italic>P<\/jats:italic> = .04]) and PC\u2010specific mortality (AHR, 13.71; 95% CI, 2.4\u201078.16 [<jats:italic>P<\/jats:italic> = .003]), with a reciprocal trend toward a decreased risk of other\u2010cause mortality (AHR, 0.18; 95% CI, 0.02\u20101.55 [<jats:italic>P<\/jats:italic> = .12]) was observed in men with low versus normal testosterone.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Low, but not necessarily castrate, testosterone levels at the time of PSA failure confer a very poor prognosis. These observations provide evidence to support testosterone testing at the time of PSA failure. Given prolonged survival when abiraterone or docetaxel is added to ADT in men with castrate\u2010sensitive metastatic PC and possibly localized high\u2010risk PC provides a rationale supporting their use with ADT in men with low testosterone in the setting of a phase 2 trial. <jats:bold><jats:italic>Cancer<\/jats:italic> 2018;124:1383\u201090.<\/jats:bold> \u00a9 <jats:italic>2017 American Cancer Society<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.31204","type":"journal-article","created":{"date-parts":[[2017,12,20]],"date-time":"2017-12-20T23:23:34Z","timestamp":1513812214000},"page":"1383-1390","source":"Crossref","is-referenced-by-count":4,"title":["Low testosterone at first prostate\u2010specific antigen failure and assessment of risk of death in men with unfavorable\u2010risk prostate cancer treated on prospective clinical trials"],"prefix":"10.1002","volume":"124","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3165-4803","authenticated-orcid":false,"given":"Katelyn M.","family":"Atkins","sequence":"first","affiliation":[{"name":"Harvard Radiation Oncology Program Dana\u2010Farber Cancer Institute and Brigham and Women's Hospital Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming\u2010Hui","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Statistics University of Connecticut Storrs Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Computer Science and Statistics University of Rhode Island Kingston Rhode Island"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1318-4238","authenticated-orcid":false,"given":"Andrew A.","family":"Renshaw","sequence":"additional","affiliation":[{"name":"Department of Pathology Baptist Hospital and Miami Cancer Institute Miami Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marian","family":"Loffredo","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Dana\u2010Farber Cancer Institute and Brigham and Women's Hospital Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7275-0597","authenticated-orcid":false,"given":"Philip W.","family":"Kantoff","sequence":"additional","affiliation":[{"name":"Department of Medicine Memorial Sloan Kettering Cancer Center New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric J.","family":"Small","sequence":"additional","affiliation":[{"name":"Department of Medicine University of California at San Francisco San Francisco California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony V.","family":"D'Amico","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Dana\u2010Farber Cancer Institute and Brigham and Women's Hospital Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,12,20]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.299.3.289"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0810095"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1012348"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.22279"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23161"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.08.904"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1405095"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(14)71205-7"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa040720"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1704174"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1702900"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2015.11.005"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)01037-5"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2015.33.18_suppl.lba5002"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.49.85"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2007.03.052"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2012.11232.x"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.3892\/ol.2017.5616"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2007.09.033"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2006.04.029"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781119196037.ch4"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.21979"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.2397-2335.1922.tb00768.x"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.2517-6161.1972.tb00899.x"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1999.10474144"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1993.10476289"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1214\/aos\/1176350951"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2016.5983"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(19970715)16:13<1515::AID-SIM572>3.0.CO;2-1"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2016.5840"}],"container-title":["Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fcncr.31204","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.31204","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T18:32:42Z","timestamp":1760293962000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncr.31204"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,12,20]]},"references-count":30,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2018,4]]}},"alternative-id":["10.1002\/cncr.31204"],"URL":"https:\/\/doi.org\/10.1002\/cncr.31204","archive":["Portico"],"relation":{},"ISSN":["0008-543X","1097-0142"],"issn-type":[{"type":"print","value":"0008-543X"},{"type":"electronic","value":"1097-0142"}],"subject":[],"published":{"date-parts":[[2017,12,20]]}}}