Bibliographic record
Abstract
Introduction: Prostate cancer (PCa) is the only cancer in men to exhibit androgen sensitivity at diagnosis, which has allowed for the development of androgen deprivation therapy (ADT); however, outcomes in high-risk PCa (HRPCa) remain significantly worse than low-risk disease, and the use of ADT varies among treatment algorithms and medical specialties.In men treated with radiation, testosterone recovery after completing ADT has been associated with oncologic outcomes; however, the relationship between testosterone recovery and oncologic outcomes following ADT in surgically managed HRPCa remains unexplored.Methods: Using pooled data from two large, phase 3 clinical trials (CALGB 90203 and SWOG S9921), we performed a retrospective analysis of men with HRPCa treated with ADT and RP.Subjects were classified as recovered or non-recovered based on study protocol-defined testosterone recovery thresholds.Primary and secondary outcomes were overall survival (OS) and modified event-free survival (mEFS), analyzed using time-to-event Kaplan-Meier estimates and Cox proportional hazards models.Additional secondary analyses repeated this on an unpooled, per-trial basis and also looked at speed of testosterone recovery using early ( ≤6 months) and late (≤12 months) recovery subgroups.Results: Among 445 eligible patients meeting our inclusion criteria, with 224 (50.4%) from the SWOG trial and 221 (49.6%) from the CALGB trial, 388 (87.2%) achieved protocol-defined testosterone recovery.No significant differences in OS (HR 0.72, 95% CI 0.31-1.69,p=0.400) or mEFS (HR 1.24, 95% CI 0.81-1.90,p=0.360) were observed between the recovered and non-recovered groups (Figure 1).Similarly, no significant differences were present when OS and mEFS were analyzed separately in each individual trial's cohort.Finally, we also saw no differences in oncologic outcomes between the early and late testosterone recovery subgroups.Conclusions: Testosterone recovery status and speed were not significantly associated with oncologic outcomes in HRPCa patients treated with RP and ADT.These findings, the first to assess this question in a surgical cohort, provide a foundation for further research into treatment strategies, including intermittent ADT and optimization of patient quality of life while maintaining oncologic efficacy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.003 | 0.000 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.001 | 0.004 |
| Research integrity | 0.007 | 0.006 |
| Insufficient payload (model declined to judge) | 0.469 | 0.212 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".