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Keywords:

  • prostate neoplasms;
  • localized;
  • testosterone;
  • prostatectomy

Study Type – Therapy (case series) Level of Evidence 4

OBJECTIVE

  • • 
    To investigate the relationship between pretreatment testosterone levels and pathological specimen characteristics, by prospectively examining serum androgen concentrations in a well-studied cohort of patients who underwent radical prostatectomy (RP) for localized prostate cancer.

PATIENTS AND METHODS

  • • 
    A total of 107 patients with clinically localized prostate cancer had an assay of total testosterone before laparoscopic RP at our institution.
  • • 
    The results were classified into two groups based on the total serum testosterone: group1, <3 ng/mL; group 2, ≥3 ng/mL.
  • • 
    Student’s t-test was used to compare continuous variables, and Fisher’s exact test or the chi-squared test was used to compare categorical variables.
  • • 
    Survival curves were established using the Kaplan–Meier method and compared using the log-rank test. In all tests, P < 0.05 was considered to indicate statistical significance.

RESULTS

  • • 
    All patients had localized prostate cancer based on digital rectal examination (DRE) and preoperative magnetic resonance imaging (MRI). Groups 1 and 2 were similar in terms of age, body mass index, preoperative co-morbidities (cardiovascular and diabetes mellitus), clinical stage of prostate cancer and preoperative PSA levels.
  • • 
    In pathological specimens, low total testosterone (<3 ng/mL) was an independent risk factor for high Gleason score (>7) and for locally advanced pathological stage (pT3 and pT4).
  • • 
    Higher preoperative testosterone correlated with disease confined to the gland.
  • • 
    There was no association between serum testosterone levels and surgical margin status, on the one hand, and biochemical recurrence on the other.

CONCLUSION

  • • 
    Low serum testosterone appears to be predictive of aggressive disease (Gleason score >7 and extraprostatic disease, pathological stage >pT2) in patients who underwent RP for localized prostate cancer.