Summary Paragraph:
The study examines testosterone recovery (TR) in prostate cancer patients undergoing androgen deprivation therapy (ADT) in conjunction with radiotherapy, as assessed across multiple randomized trials by the MARCAP Consortium. Variabilities in TR were identified based on ADT duration, baseline testosterone levels, and patient age. The study provided TR timelines towards noncastrate and nonhypogonadal levels, demonstrating a complex non-linear relationship between TR and metastasis-free survival (MFS). Findings suggest that for 6-month ADT courses, maintaining castrate testosterone levels for 11 months optimizes MFS, offering valuable insights for clinical decision-making, particularly concerning newer GnRH antagonists that expedite TR. The study also highlighted that prolonged effective castration periods might increase oncological benefits in some patient cohorts, though these observations warrant further research for confirmation.