title: Recovery of serum testosterone following neoadjuvant and adjuvant androgen deprivation therapy in men treated with prostate brachytherapy.
abstract: OBJECTIVE
  To investigate the time course of testosterone (T) recovery after cessation of androgen deprivation therapy (ADT) in patients treated with brachytherapy.
  
  
  METHODS
  One-hundred and seventy-four patients treated between June 1999 and February 2009 were studied. Patients were divided into a short-term usage group (≤ 12 mo, n = 91) and a long-term usage group (≥ 36 mo, n = 83) according to the duration of gonadotropin-releasing hormone agonist therapy. Median follow-up was 29 mo in the short-term group and was 60 mo in the long-term group.
  
  
  RESULTS
  Cumulative incidence rates of T recovery to normal and supracastrate levels at 24 mo after cessation were 28.8% and 74.6%, respectively, in the long-term usage group, whereas these values were 96.4% and 98.8% in the short-term usage group. T recovery to normal and supracastrate levels occurred significantly more rapidly in the short-term than in the long-term usage group (P < 0.001 and P < 0.001, respectively). Five years after cessation, 22.6% of patients maintained a castrate T level in the long-term usage group. On multivariate analysis, lower T levels (< 10 ng/dL) at cessation of ADT was significantly associated with prolonged T recovery to supracastrate levels in the long-term usage group (P = 0.002).
  
  
  CONCLUSIONS
  Lower T levels at cessation of ADT were associated with prolonged T recovery in the long-term usage group. Five years after cessation of long-term ADT, approximately one-fifth of patients still had castrate T levels. When determining the therapeutic effect, especially biochemical control, we should consider this delay in T recovery.
authors.affiliation: Hideyasu Tsumura, Takefumi Satoh, Shuhei Hirano, Ken-ichi Tabata, Shinji Kurosaka, Kazumasa Matsumoto, Tetsuo Fujita, Shiro Baba, Masatsugu Iwamura, Department of Urology, Kitasato University School of Medicine, Sagamihara 252-0374, Japan.
authors.forename: Hideyasu
authors.initials: H
authors.lastname: Tsumura
authors.affiliation: Hideyasu Tsumura, Takefumi Satoh, Shuhei Hirano, Ken-ichi Tabata, Shinji Kurosaka, Kazumasa Matsumoto, Tetsuo Fujita, Shiro Baba, Masatsugu Iwamura, Department of Urology, Kitasato University School of Medicine, Sagamihara 252-0374, Japan.
authors.forename: Takefumi
authors.initials: T
authors.lastname: Satoh
authors.affiliation: Hideyasu Tsumura, Takefumi Satoh, Shuhei Hirano, Ken-ichi Tabata, Shinji Kurosaka, Kazumasa Matsumoto, Tetsuo Fujita, Shiro Baba, Masatsugu Iwamura, Department of Urology, Kitasato University School of Medicine, Sagamihara 252-0374, Japan.
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Ishiyama
authors.affiliation: Hideyasu Tsumura, Takefumi Satoh, Shuhei Hirano, Ken-ichi Tabata, Shinji Kurosaka, Kazumasa Matsumoto, Tetsuo Fujita, Shiro Baba, Masatsugu Iwamura, Department of Urology, Kitasato University School of Medicine, Sagamihara 252-0374, Japan.
authors.forename: Shuhei
authors.initials: S
authors.lastname: Hirano
authors.affiliation: Hideyasu Tsumura, Takefumi Satoh, Shuhei Hirano, Ken-ichi Tabata, Shinji Kurosaka, Kazumasa Matsumoto, Tetsuo Fujita, Shiro Baba, Masatsugu Iwamura, Department of Urology, Kitasato University School of Medicine, Sagamihara 252-0374, Japan.
authors.forename: Ken-Ichi
authors.initials: K
authors.lastname: Tabata
authors.affiliation: Hideyasu Tsumura, Takefumi Satoh, Shuhei Hirano, Ken-ichi Tabata, Shinji Kurosaka, Kazumasa Matsumoto, Tetsuo Fujita, Shiro Baba, Masatsugu Iwamura, Department of Urology, Kitasato University School of Medicine, Sagamihara 252-0374, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Kurosaka
authors.affiliation: Hideyasu Tsumura, Takefumi Satoh, Shuhei Hirano, Ken-ichi Tabata, Shinji Kurosaka, Kazumasa Matsumoto, Tetsuo Fujita, Shiro Baba, Masatsugu Iwamura, Department of Urology, Kitasato University School of Medicine, Sagamihara 252-0374, Japan.
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Matsumoto
authors.affiliation: Hideyasu Tsumura, Takefumi Satoh, Shuhei Hirano, Ken-ichi Tabata, Shinji Kurosaka, Kazumasa Matsumoto, Tetsuo Fujita, Shiro Baba, Masatsugu Iwamura, Department of Urology, Kitasato University School of Medicine, Sagamihara 252-0374, Japan.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Fujita
authors.affiliation: Hideyasu Tsumura, Takefumi Satoh, Shuhei Hirano, Ken-ichi Tabata, Shinji Kurosaka, Kazumasa Matsumoto, Tetsuo Fujita, Shiro Baba, Masatsugu Iwamura, Department of Urology, Kitasato University School of Medicine, Sagamihara 252-0374, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Kitano
authors.affiliation: Hideyasu Tsumura, Takefumi Satoh, Shuhei Hirano, Ken-ichi Tabata, Shinji Kurosaka, Kazumasa Matsumoto, Tetsuo Fujita, Shiro Baba, Masatsugu Iwamura, Department of Urology, Kitasato University School of Medicine, Sagamihara 252-0374, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Baba
authors.affiliation: Hideyasu Tsumura, Takefumi Satoh, Shuhei Hirano, Ken-ichi Tabata, Shinji Kurosaka, Kazumasa Matsumoto, Tetsuo Fujita, Shiro Baba, Masatsugu Iwamura, Department of Urology, Kitasato University School of Medicine, Sagamihara 252-0374, Japan.
authors.forename: Kazushige
authors.initials: K
authors.lastname: Hayakawa
authors.affiliation: Hideyasu Tsumura, Takefumi Satoh, Shuhei Hirano, Ken-ichi Tabata, Shinji Kurosaka, Kazumasa Matsumoto, Tetsuo Fujita, Shiro Baba, Masatsugu Iwamura, Department of Urology, Kitasato University School of Medicine, Sagamihara 252-0374, Japan.
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Iwamura
keywords: Androgen deprivation; Gonadotropin-releasing hormone agonist; Prostate brachytherapy; Prostate cancer; Testosterone