Low pretreatment total testosterone (<3 ng/mL) predicts extraprostatic disease in prostatectomy specimens from patients with preoperative localized prostate cancer
Article first published online: 2 NOV 2010
© 2010 THE AUTHORS. BJU INTERNATIONAL © 2010 BJU INTERNATIONAL
Volume 107, Issue 9, pages 1400–1403, May 2011
How to Cite
Xylinas, E., Ploussard, G., Durand, X., Fabre, A., Salomon, L., Allory, Y., Vordos, D., Hoznek, A., Abbou, C. C. and de la Taille, A. (2011), Low pretreatment total testosterone (<3 ng/mL) predicts extraprostatic disease in prostatectomy specimens from patients with preoperative localized prostate cancer. BJU International, 107: 1400–1403. doi: 10.1111/j.1464-410X.2010.09816.x
- Issue published online: 21 APR 2011
- Article first published online: 2 NOV 2010
- Accepted for publication 25 May 2010
- prostate neoplasms;
Study Type – Therapy (case series) Level of Evidence 4
- • 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.
- • 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.
- • 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.