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Loughlin KR. The Prostate as an Endocrine Organ. Urol Clin North Am 2022; 49:695-697. [DOI: 10.1016/j.ucl.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Taussky D, Delouya G, Lambert C, Bahary J, Saad F. The relationship between pre‐radiation therapy testosterone levels and prostate cancer aggressiveness. Andrologia 2020; 52:e13731. [DOI: 10.1111/and.13731] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/28/2020] [Accepted: 06/03/2020] [Indexed: 01/20/2023] Open
Affiliation(s)
- Daniel Taussky
- Department of Radiation Oncology Centre Hospitalier de l'Université de Montréal (CHUM) Montreal QC Canada
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM) Montreal QC Canada
| | - Guila Delouya
- Department of Radiation Oncology Centre Hospitalier de l'Université de Montréal (CHUM) Montreal QC Canada
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM) Montreal QC Canada
| | - Carole Lambert
- Department of Radiation Oncology Centre Hospitalier de l'Université de Montréal (CHUM) Montreal QC Canada
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM) Montreal QC Canada
| | - Jean‐Paul Bahary
- Department of Radiation Oncology Centre Hospitalier de l'Université de Montréal (CHUM) Montreal QC Canada
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM) Montreal QC Canada
| | - Fred Saad
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM) Montreal QC Canada
- Division of Urology Centre Hospitalier de l’Université de Montréal Montreal QC Canada
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Tokiwa S, Shimmura H, Nomura S, Watanabe R, Kurita M, Yoshida N, Yamashita K, Nishikawa Y, Kouzmenko A, Kato S. Degarelix treatment is compatible with diabetes and antithrombotic therapy in patients with prostate cancer. Res Rep Urol 2017; 9:225-232. [PMID: 29264358 PMCID: PMC5724412 DOI: 10.2147/rru.s146180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Introduction Therapeutically induced androgen deficiency (AD) is a standard treatment for patients with prostate cancer, but it is often associated with various adverse effects (AEs) that may lead to discontinuation. Some AEs may depend on the patient's health condition, while others may be due to complications of the drug delivery method. Degarelix is a gonadotropin-releasing hormone (GnRH) antagonist widely used for the treatment of androgen-dependent prostate cancer. This study aimed to ascertain the following: 1) the compatibility of degarelix treatment with diabetes and 2) any specific causal associations of degarelix injections with increased blood clotting and antithrombotic therapy requirements. Patients and methods The medical records of 162 patients with prostate cancer who had undergone degarelix treatment were retrospectively examined. The association of a medical history of diabetes and anticoagulant co-treatment with degarelix treatment discontinuation was analyzed statistically. Results Rapid and significant decreases in prostate-specific antigen (PSA) levels during the course of degarelix treatment were detected for patients with prostate cancer regardless of clinical state. During the 27 months of treatment, 68 subjects (48%) ceased degarelix treatment, owing to several reasons, mainly financial issues. Among these subjects, 19 had diabetes, while 35 were treated with antithrombotics. Extensive statistical analysis indicated that there were no causal associations between degarelix treatment discontinuation and preexisting diabetes or antithrombotic therapy. Conclusion Our study suggests that preexisting diabetes and antithrombotic therapy were not significant factors for the discontinuation of degarelix treatment in patients with prostate cancer.
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Affiliation(s)
- Suguru Tokiwa
- Department of Urology, Jyoban Hospital, Tokiwa Foundation, Iwaki, Fukushima, Japan
| | - Hiroaki Shimmura
- Department of Urology, Jyoban Hospital, Tokiwa Foundation, Iwaki, Fukushima, Japan
| | - Shuhei Nomura
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.,Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo.,Research Institute of Innovative Medicine, Tokiwa Foundation, Iwaki
| | - Ryota Watanabe
- Department of Urology, Jyoban Hospital, Tokiwa Foundation, Iwaki, Fukushima, Japan
| | - Minoru Kurita
- Department of Urology, Jyoban Hospital, Tokiwa Foundation, Iwaki, Fukushima, Japan
| | - Naoto Yoshida
- Department of Urology, Jyoban Hospital, Tokiwa Foundation, Iwaki, Fukushima, Japan
| | - Kaori Yamashita
- Department of Urology, Jyoban Hospital, Tokiwa Foundation, Iwaki, Fukushima, Japan
| | - Yoshitaka Nishikawa
- Department of Health Informatics, School of Public Health, Kyoto University, Kyoto, Japan
| | - Alexander Kouzmenko
- Department of Life Sciences, Alfaisal University, Riyadh, Kingdom of Saudi Arabia
| | - Shigeaki Kato
- Research Institute of Innovative Medicine, Tokiwa Foundation, Iwaki
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Hormonal changes after localized prostate cancer treatment. Comparison between external beam radiation therapy and radical prostatectomy. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.acuroe.2016.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Hormonal changes after localized prostate cancer treatment. Comparison between external beam radiation therapy and radical prostatectomy. Actas Urol Esp 2016; 40:549-555. [PMID: 27207596 DOI: 10.1016/j.acuro.2016.02.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 02/22/2016] [Accepted: 02/22/2016] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the influence of radical prostatectomy (RP) and external beam radiation therapy (EBRT) on the hypothalamic pituitary axis of 120 men with clinically localized prostate cancer treated with RP or EBRT exclusively. MATERIALS AND METHODS 120 patients with localized prostate cancer were enrolled. Ninety two patients underwent RP and 28 patients EBRT exclusively. We measured serum levels of luteinizing hormone, follicle stimulating hormone (FSH), total testosterone (T), free testosterone, and estradiol at baseline and at 3 and 12 months after treatment completion. RESULTS Patients undergoing RP were younger and presented a higher prostate volume (64.3 vs. 71.1 years, p<0.0001 and 55.1 vs. 36.5 g, p<0.0001; respectively). No differences regarding serum hormonal levels were found at baseline. Luteinizing hormone and FSH levels were significantly higher in those patients treated with EBRT at three months (luteinizing hormone 8,54 vs. 4,76 U/l, FSH 22,96 vs. 8,18 U/l, p<0,0001) while T and free testosterone levels were significantly lower (T 360,3 vs. 414,83ng/dl, p 0,039; free testosterone 5,94 vs. 7,5pg/ml, p 0,018). At 12 months FSH levels remained significantly higher in patients treated with EBRT compared to patients treated with RP (21,01 vs. 8,51 U/l, p<0,001) while T levels remained significantly lower (339,89 vs. 402,39ng/dl, p 0,03). CONCLUSIONS Prostate cancer treatment influences the hypothalamic pituitary axis. This influence seems to be more important when patients with prostate cancer are treated with EBRT rather than RP. More studies are needed to elucidate the role that prostate may play as an endocrine organ.
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Gacci M, Baldi E, Tamburrino L, Detti B, Livi L, De Nunzio C, Tubaro A, Gravas S, Carini M, Serni S. Quality of Life and Sexual Health in the Aging of PCa Survivors. Int J Endocrinol 2014; 2014:470592. [PMID: 24744780 PMCID: PMC3976934 DOI: 10.1155/2014/470592] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2013] [Accepted: 02/02/2014] [Indexed: 12/19/2022] Open
Abstract
Prostate cancer (PCa) is the most common malignancy in elderly men. The progressive ageing of the world male population will further increase the need for tailored assessment and treatment of PCa patients. The determinant role of androgens and sexual hormones for PCa growth and progression has been established. However, several trials on androgens and PCa are recently focused on urinary continence, quality of life, and sexual function, suggesting a new point of view on the whole endocrinological aspect of PCa. During aging, metabolic syndrome, including diabetes, hypertension, dyslipidemia, and central obesity, can be associated with a chronic, low-grade inflammation of the prostate and with changes in the sex steroid pathways. These factors may affect both the carcinogenesis processes and treatment outcomes of PCa. Any treatment for PCa can have a long-lasting negative impact on quality of life and sexual health, which should be assessed by validated self-reported questionnaires. In particular, sexual health, urinary continence, and bowel function can be worsened after prostatectomy, radiotherapy, or hormone treatment, mostly in the elderly population. In the present review we summarized the current knowledge on the role of hormones, metabolic features, and primary treatments for PCa on the quality of life and sexual health of elderly Pca survivors.
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Affiliation(s)
- Mauro Gacci
- Department of Urology, University of Florence, Careggi Hospital, Viale Gramsci 7, 50121 Florence, Italy
| | - Elisabetta Baldi
- Department of Experimental and Clinical Biomedical Sciences, Section of Clinical Pathophysiology, University of Florence, Italy
| | - Lara Tamburrino
- Department of Experimental and Clinical Biomedical Sciences, Section of Clinical Pathophysiology, University of Florence, Italy
| | - Beatrice Detti
- Radiotherapy, University Hospital Careggi, University of Florence, Italy
| | - Lorenzo Livi
- Radiotherapy, University Hospital Careggi, University of Florence, Italy
| | - Cosimo De Nunzio
- Department of Urology, Sant'Andrea Hospital, University “La Sapienza”, Rome, Italy
| | - Andrea Tubaro
- Department of Urology, Sant'Andrea Hospital, University “La Sapienza”, Rome, Italy
| | - Stavros Gravas
- Department of Urology, University Hospital of Larissa, Larissa, Greece
| | - Marco Carini
- Department of Urology, University of Florence, Careggi Hospital, Viale Gramsci 7, 50121 Florence, Italy
| | - Sergio Serni
- Department of Urology, University of Florence, Careggi Hospital, Viale Gramsci 7, 50121 Florence, Italy
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Gacci M, Tosi N, Vittori G, Minervini A, Corona G, Cai T, Morelli AM, Vignozzi L, Serni S, Maggi M, Carini M. Changes in sex hormone levels after radical prostatectomy: Results of a longitudinal cohort study. Oncol Lett 2013; 6:529-533. [PMID: 24137361 PMCID: PMC3789060 DOI: 10.3892/ol.2013.1420] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Accepted: 03/28/2013] [Indexed: 11/16/2022] Open
Abstract
The changes in testosterone and gonadotropin levels in patients who have undergone radical prostatectomy (RP) for clinically localized prostate cancer (PCa) remain unclear. The aim of the present study was to prospectively evaluate the changes in serum testosterone (Te), luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels in the early months after RP for PCa and the correlation between these hormones at various follow-up times. A total of 100 male patients with clinically localized PCa were consecutively included in the study. The serum levels of Te, LH and FSH were measured prior to RP (baseline) and at 1 and 3 months post-operatively. Changes in the levels of Te, LH and FSH between the baseline and at 1 and 3 months after RP were analyzed with paired sample t-tests. The correlations between LH and Te levels at the various follow-up times were evaluated with a Spearman’s rank correlation coefficient. At 1 month subsequent to RP, the Te levels were significantly decreased (baseline vs. 1 month, P=0.021) and subsequently recovered to the pre-operative value at 3 months (baseline vs. 3 months, P=0.372). The mean Te level at baseline was 15.3 nmol/l, while at 1 and 3 months it was 13.8 and 14.4 nmol/l, respectively. By contrast, the levels of LH and FSH were significantly increased at 1 and 3 months post-surgery, compared with the baseline value (baseline vs. 1 or 3 months, P<0.0001). The pre-operative correlation between LH and Te was lost 1 month after RP and recovered after 3 months. Notably, the LH level at 1 month was markedly correlated with the Te levels recorded after 3 months. In the present study, patients developed compensated hypergonadotropic hypogonadism 3 months after RP.
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Affiliation(s)
- Mauro Gacci
- Department of Urology, University of Florence, Florence, Italy
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Circulating sex steroids and prostate cancer: introducing the time-dependency theory. World J Urol 2013; 31:267-73. [PMID: 23283410 DOI: 10.1007/s00345-012-1009-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Accepted: 12/09/2012] [Indexed: 10/27/2022] Open
Abstract
PURPOSE We sought whether serum total testosterone (tT), estradiol (E2), tT/E2 ratio, and sex hormone-binding globulin (SHBG) significantly fluctuate throughout time in men with prostate cancer (PCa). METHODS Circulating hormones were measured in a cohort of 631 candidates for radical prostatectomy. Hormone levels were analyzed according to either patient age, stratified into quartiles, or body mass index (BMI). Linear regression analyses tested the association between sex steroids and continuously coded patient age and BMI values. RESULTS No significant differences were found among age quartiles regarding serum tT levels and tT/E2 ratio. Conversely, E2 and SHBG levels significantly increased throughout time (all, p ≤ 0.001). Total T did not linearly change according to continuously coded patient age; in contrast, E2 and SHBG linearly increased (all, p ≤ 0.001), whereas tT/E2 decreased (p = 0.016) with aging. Rate of hypogonadism significantly increased with aging (p = 0.04). Total T, T/E2 ratio, and SHBG linearly decreased along with BMI increases (all p ≤ 0.02), whereas serum E2 did not significantly change. Rate of hypogonadism significantly increased with BMI increases (p < 0.001). CONCLUSIONS In contrast with longitudinal studies in the general male population, these data indirectly suggest that serum tT levels could be stable over time in PCa patients. This finding led to formulation of a "time-dependency theory", which postulates that the endocrine biology of prostate tissue is dependent on the exposure time at a given concentration of sex steroid, which, in turn, fluctuates throughout the lifespan of the individual.
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Botto H, Neuzillet Y, Lebret T, Camparo P, Molinie V, Raynaud JP. High incidence of predominant Gleason pattern 4 localized prostate cancer is associated with low serum testosterone. J Urol 2011; 186:1400-5. [PMID: 21855947 DOI: 10.1016/j.juro.2011.05.082] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2011] [Indexed: 11/26/2022]
Abstract
PURPOSE We characterized the aggressiveness of prostate cancer by Gleason score and predominant Gleason pattern in relation to preoperative serum testosterone. MATERIALS AND METHODS In a prospective study serum total testosterone was measured preoperatively in patients referred to our department from January 2007 to January 2011 for radical prostatectomy. Gleason score and predominant Gleason pattern were determined in prostate biopsy and prostate tissue specimens. RESULTS A total of 431 patients were enrolled in the study. In biopsies a predominant Gleason pattern 4 was observed in 72 patients (17%). In prostate specimens the predominant Gleason pattern 4 increased to 132 patients (31%). In the 132 patients total testosterone was lower than in the 299 with predominant Gleason pattern 3 (4.00 vs 4.50 ng/ml, p = 0.001), prostate specific antigen was higher (8.4 vs 6.6 ng/ml, p <0.00001), and extraprostatic extension and positive margins were noted more often (49% vs 20% and 23% vs 14%, p <0.000001 and 0.02, respectively). The 62 patients with total testosterone less than 3.0 ng/ml were larger (mean 7 kg, p = 0.0001) with a higher body mass index (mean 0.5 kg/m(2), p <0.000001). They had a higher percent of Gleason score with predominant Gleason pattern 4 (47% vs 28%, p = 0.002). CONCLUSIONS Low total testosterone is associated with a higher percent of predominant Gleason pattern 4, a signature of prostate cancer aggressiveness. Tumor aggressiveness cannot be accurately estimated by biopsy Gleason score and predominant Gleason pattern. Preoperative total testosterone should be added to prostate specific antigen determination to improve management for prostate cancer.
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Affiliation(s)
- Henry Botto
- Department of Urology, Foch Hospital, Suresnes, France.
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Salonia A, Gallina A, Briganti A, Abdollah F, Suardi N, Capitanio U, Colombo R, Freschi M, Rigatti P, Montorsi F. Preoperative hypogonadism is not an independent predictor of high-risk disease in patients undergoing radical prostatectomy. Cancer 2011; 117:3953-62. [DOI: 10.1002/cncr.25985] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2010] [Revised: 11/03/2010] [Accepted: 11/04/2010] [Indexed: 11/10/2022]
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De Nunzio C, Carluccini A, Cicione A, Squillacciotti S, Trucchi A, Cantiani A, Leonardo C, Tubaro A. Prostate cancer does not influence androgen levels: a radical prostatectomy cohort study. Urol Int 2011; 86:161-6. [PMID: 21252482 DOI: 10.1159/000322964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2010] [Accepted: 11/18/2010] [Indexed: 11/19/2022]
Abstract
AIM To investigate the relationship between androgens and prostate cancer in patients scheduled for radical prostatectomy. SUBJECTS AND METHODS Patients scheduled for open radical prostatectomy were enrolled. Blood samples were collected before prostate biopsy and 12 months later to evaluate testosterone, free testosterone, sex hormone-binding globulin (SHBG), PSA, calculated free and bioavailable testosterone. RESULTS 44 patients were consecutively enrolled. 15 patients (34%) presented a Gleason score (GS) of 6, 24 patients GS 7 (54%), 1 patient (2%) GS 8, and 4 patients GS 9 (9%). Mean prostate cancer volume was 4.3 ± 5.7 cm(3). 24 patients presented a pT2 stage, 16 a pT3a stage, and 4 a pT3b stage. Positive surgical margins were detected in 12 patients (27.3%). No significant change of testosterone (4.21 ± 1.49 vs. 4.00 ± 1.48 ng/ml, p = 0.46), free testosterone (9.01 ± 3.64 vs. 8.85 ± 3.04 pg/ml, p = 0.83), SHBG (38 ± 14.39 vs. 38.5 ± 17.23 nmol/l, p = 0.71), calculated free testosterone (0.091 ± 0.13 vs. 0.067 ± 0.026, p = 0.563), and bioavailable testosterone (1.89 ± 0.722 vs. 1.88 ± 0.53, p = 0.912) was observed. CONCLUSIONS In our single-center study, prostate cancer does not impact on serum androgen levels, however our results should be confirmed in a larger study.
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Affiliation(s)
- Cosimo De Nunzio
- Department of Urology, Ospedale Sant'Andrea, University La Sapienza, Rome, Italy. cosimodenunzio @ virgilio.it
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Olsson M, Ekström L, Schulze J, Kjellman A, Akre O, Rane A, Gustafsson O. Radical prostatectomy: influence on serum and urinary androgen levels. Prostate 2010; 70:200-5. [PMID: 19760638 DOI: 10.1002/pros.21053] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The role of the prostate as an active endocrine organ and the hormonal changes after radical prostatectomy (RP) has not been well studied. The objective of this study was to investigate the serum and urine hormonal changes after RP. METHODS Fifty-five healthy men with localized prostate cancer were enrolled in this cross-sectional study at a single academic center. We measured serum levels of testosterone, dihydrotestosterone (DHT), sex hormone binding globulin (SHBG), luteinizing hormone (LH), and follicle stimulating hormone (FSH) in all 55 patients preoperatively and in 53 patients 90 days postoperatively. Free testosterone was calculated in all patients. Inhibin B levels was analyzed in 44 patients pre- and postoperatively. Steroid urine profile including testosterone, DHT, 5alpha-androstane-3alpha,17beta-diol (3alphaAdiol), and androsterone (ADT) was also determined preoperatively and 90 days postoperatively in 18 patients. RESULTS There were 53% increase in serum LH (P < 0.0001), 21% increase in serum FSH (P < 0.0001), and 13% decrease in DHT levels (P < 0.03). There were no significant changes in any other serum hormone investigated. Urinary levels of DHT glucuronides (DHT-G) decreased by 67% (P < 0.0003) while Androsterone-G and 3alphaAdiol-G increased by 37% (P = 0.019) and 44% (P = 0.023), respectively. There were no alterations in the urinary levels of the other steroids investigated. Inhibin B levels correlated inversely with both FSH (r = -0.67, P < 0.0001) and LH (r = -0.51, P = 0.0004). CONCLUSION RP leads to significant increases in serum gonadotropins and significant DHT decrease in both serum and urine. These hormonal changes are independent of inhibin B.
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Affiliation(s)
- Mats Olsson
- Division of Urology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
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Botto H, Neuzillet Y, Lebret T, Camparo P, Molinie V, Raynaud JP. Preoperative low serum testosterone levels are associated with tumor aggressiveness in radical prostatectomy treated cancer patients. Horm Mol Biol Clin Investig 2010; 2:191-201. [DOI: 10.1515/hmbci.2010.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2009] [Accepted: 01/12/2010] [Indexed: 11/15/2022]
Abstract
Abstract: The aim of this study was to characterize the aggressiveness of prostate cancer as assessed by the Gleason score (GS), the predominant Gleason pattern (pGP), and testosterone (T) serum concentration.: A total of 247 patients, referred to our Department (from January 2007 to December 2009) for a radical prostatectomy, underwent preoperative T and bioavailable testosterone (samplings between 07:00 and 10:00 h). Serum determinations (radioimmunoassayed in a central laboratory). GS and pGP were determined in prostate biopsies and prostate tissue specimens.: In biopsy specimens, a GS7 was observed in 105 (43%) patients; 25 (10%) had pGP4. In prostate specimens, 163 (66%) had a GS7; 60 (24%) had pGP4. For prostate specimens, comparing the 75 patients with pGP4 (GS 4+3, 4+4 and 4+5) to the 172 with pGP3 (GS 3+3 and 3+4), T was lower (4.03 vs. 4.75 ng/mL, p=0.003) and prostrate-specific antigen (PSA) higher (11.1 vs. 7.3 ng/mL, p<0.00001). Extra prostatic extension and positive margins were observed more frequently (52% vs. 18%, p<0.000001 and 29% vs. 15%, p=0.009, respectively). The 40 patients with T <3.0 ng/mL were larger (+5 kg, body mass index: +1.7 kg/m: Aggressiveness of the tumor cannot be properly estimated by the GS and pGP found in biopsies. The pGP in prostate specimens is of paramount importance, particularly in the case of a Gleason 7, to appreciate the outcomes and to choose the treatment. Preoperative testosterone should be added to PSA determination to improve prediction of treatment outcomes.
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