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Kontogiannis S, Markantes G, Stamou M, Tsagkarakis M, Mamali I, Giannitsas K, Perimenis P, Georgopoulos N, Athanasopoulos A. Anti-Müllerian hormone: a novel biomarker for aggressive prostate cancer? Emerging evidence from a prospective study of radical prostatectomies. Hormones (Athens) 2024; 23:297-304. [PMID: 38127275 PMCID: PMC11190032 DOI: 10.1007/s42000-023-00520-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 12/11/2023] [Indexed: 12/23/2023]
Abstract
PURPOSE Prostate cancer patients are a heterogeneous group as regards the aggressiveness of the disease. The relationship of steroid hormones with the aggressiveness of prostate cancer is unclear. It is known that the anti-Müllerian hormone (AMH) inhibits prostate cancer cell lines in vitro. The aim of this study is to investigate the relationship of AMH and steroid hormones with the aggressiveness of prostate cancer. METHODS This was a prospective study of consecutive radical prostatectomy patients. We measured the following hormones: total testosterone, sex hormone-binding globulin, albumin, luteinizing hormone, follicle-stimulating hormone, estradiol, dehydroepiandrosterone sulfate, androstenedione, and AMH. The minimum follow-up after radical prostatectomy was 5 years. For the aggressiveness of prostate cancer, we considered the following three variables: post-operative Gleason score (GS) ≥ 8, TNM pΤ3 disease, and prostate-specific antigen (PSA) biochemical recurrence (BCR). RESULTS In total, 91 patients were enrolled. The mean age and PSA were 64.8 years and 9.3 ng/dl, respectively. The median post-operative GS was 7. Low AMH blood levels were correlated with higher post-operative GS (p = 0.001), as well as with PSA BCR (p = 0.043). With pT3 disease, only albumin was (negatively) correlated (p = 0.008). ROC analysis showed that AMH is a good predictor of BCR (AUC 0.646, 95% CI 0.510-0.782, p = 0.043); a cutoff value of 3.06 ng/dl had a positive prognostic value of 71.4% and a negative prognostic value of 63.3% for BCR. Cox regression analysis showed that AMH is a statistically significant and independent prognostic marker for BCR (p = 0.013). More precisely, for every 1 ng/ml of AMH rise, the probability for PSA BCR decreases by 20.8% (HR = 0.792). Moreover, in Kaplan-Meier analysis, disease-free survival is more probable in patients with AMΗ ≥ 3.06 ng/ml (p = 0.004). CONCLUSIONS Low AMH blood levels were correlated with aggressive prostate cancer in this radical prostatectomy cohort of patients. Therefore, AMH could be a prognostic biomarker for the aggressiveness of the disease.
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Affiliation(s)
| | | | - Maria Stamou
- Harvard Reproductive Sciences Center, Massachusetts General Hospital, Boston, MA, USA
| | | | - Irini Mamali
- Endocrinology Department, Patras University Hospital, Patras, Greece
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Dias A, Brook MN, Bancroft EK, Page EC, Chamberlain A, Saya S, Amin J, Mikropoulos C, Taylor N, Myhill K, Thomas S, Saunders E, Dadaev T, Leongamornlert D, Dyrsø Jensen T, Evans DG, Cybulski C, Liljegren A, Teo SH, Side L, Kote‐Jarai Z, Eeles RA. Serum testosterone and prostate cancer in men with germline BRCA1/2 pathogenic variants. BJUI COMPASS 2023; 4:361-373. [PMID: 37025481 PMCID: PMC10071088 DOI: 10.1002/bco2.156] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 04/10/2022] [Accepted: 04/12/2022] [Indexed: 01/11/2023] Open
Abstract
Objectives The relation of serum androgens and the development of prostate cancer (PCa) is subject of debate. Lower total testosterone (TT) levels have been associated with increased PCa detection and worse pathological features after treatment. However, data from the Reduction by Dutasteride of Prostate Cancer Events (REDUCE) and Prostate Cancer Prevention (PCPT) trial groups indicate no association. The aim of this study is to investigate the association of serum androgen levels and PCa detection in a prospective screening study of men at higher genetic risk of aggressive PCa due to BRCA1/2 pathogenic variants (PVs), the IMPACT study. Methods Men enrolled in the IMPACT study provided serum samples during regular visits. Hormonal levels were calculated using immunoassays. Free testosterone (FT) was calculated from TT and sex hormone binding globulin (SHBG) using the Sodergard mass equation. Age, body mass index (BMI), prostate-specific antigen (PSA) and hormonal concentrations were compared between genetic cohorts. We also explored associations between age and TT, SHBG, FT and PCa, in the whole subset and stratified by BRCA1/2 PVs status. Results A total of 777 participants in the IMPACT study had TT and SHBG measurements in serum samples at annual visits, giving 3940 prospective androgen levels, from 266 BRCA1 PVs carriers, 313 BRCA2 PVs carriers and 198 non-carriers. The median number of visits per patient was 5. There was no difference in TT, SHBG and FT between carriers and non-carriers. In a univariate analysis, androgen levels were not associated with PCa. In the analysis stratified by carrier status, no significant association was found between hormonal levels and PCa in non-carriers, BRCA1 or BRCA2 PVs carriers. Conclusions Male BRCA1/2 PVs carriers have a similar androgen profile to non-carriers. Hormonal levels were not associated with PCa in men with and without BRCA1/2 PVs. Mechanisms related to the particularly aggressive phenotype of PCa in BRCA2 PVs carriers may therefore not be linked with circulating hormonal levels.
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Affiliation(s)
- Alexander Dias
- Oncogenetics TeamThe Institute of Cancer ResearchLondonUK
- Instituto Nacional de Cancer Jose de Alencar Gomes da Silva INCARio de JaneiroBrazil
| | - Mark N. Brook
- Oncogenetics TeamThe Institute of Cancer ResearchLondonUK
| | - Elizabeth K. Bancroft
- Oncogenetics TeamThe Institute of Cancer ResearchLondonUK
- Academic Urology UnitRoyal Marsden NHS Foundation TrustLondonUK
| | | | | | - Sibel Saya
- Oncogenetics TeamThe Institute of Cancer ResearchLondonUK
| | - Jan Amin
- Clinical Biochemistry SectionRoyal Marsden NHS Foundation TrustLondonUK
| | - Christos Mikropoulos
- Oncogenetics TeamThe Institute of Cancer ResearchLondonUK
- Academic Urology UnitRoyal Marsden NHS Foundation TrustLondonUK
| | - Natalie Taylor
- Oncogenetics TeamThe Institute of Cancer ResearchLondonUK
- Academic Urology UnitRoyal Marsden NHS Foundation TrustLondonUK
| | - Kathryn Myhill
- Oncogenetics TeamThe Institute of Cancer ResearchLondonUK
- Academic Urology UnitRoyal Marsden NHS Foundation TrustLondonUK
| | - Sarah Thomas
- Oncogenetics TeamThe Institute of Cancer ResearchLondonUK
| | | | - Tokhir Dadaev
- Oncogenetics TeamThe Institute of Cancer ResearchLondonUK
| | | | | | - D. Gareth Evans
- Genetic Medicine, Manchester Academic Health Sciences CentreCentral Manchester University Hospitals NHS Foundation TrustManchesterUK
| | - Cezary Cybulski
- International Hereditary Cancer Center, Department of Genetics and PathologyPomeranian Medical University in SzczecinSzczecinPoland
| | - Annelie Liljegren
- Karolinska University Hospital and Karolinska InstitutetStockholmSweden
| | - Soo H. Teo
- Cancer Research Initiatives FoundationSubang Jaya Medical CentreSelangorDarul EhsanMalaysia
| | - Lucy Side
- Wessex Clinical Genetics ServicePrincess Anne HospitalSouthamptonUK
| | | | | | - Rosalind A. Eeles
- Oncogenetics TeamThe Institute of Cancer ResearchLondonUK
- Academic Urology UnitRoyal Marsden NHS Foundation TrustLondonUK
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Pikramenos K, Zachou M, Papadopoulos D, Papatsoris A, Varkarakis I, Mitsogiannis I. Post Radical Prostatectomy Erectile Dysfunction. A Single Centre Experience. Cureus 2023; 15:e34601. [PMID: 36883073 PMCID: PMC9985922 DOI: 10.7759/cureus.34601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2023] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION This study aims to determine the effects of radical retropubic prostatectomy on post-operative erectile function. MATERIALS & METHODS A total of 50 patients were included in this study, diagnosed with localized prostate cancer, and underwent nerve-sparing radical retropubic prostatectomy. All patients completed the International Index of Erectile Function (IIEF-5) questionnaire pre-operatively and on the third, sixth, and twelfth post-operative month and completed a self-reporting of their satisfaction with their sexual performance. Patients with a history of severe heart disease, were on erectile dysfunction medication, or had a score of 7 or less on the IIEF-5 questionnaire, were excluded from the study. RESULTS Pre-operatively it was observed that the lower the IIEF-5 score, the higher the biopsy Gleason score. Post-operatively, 16 patients stated that erectile function had returned to the pre-operative IIEF-5 category. In contrast, only 13 of them stated they were happy with their sexual performance on the self-reporting scale. The rest reported dissatisfaction despite returning to their pre-operative erectile function status. IIEF-5 scores were also different when compared amongst the four age groups, with scores indicating that younger age is related to higher IIEF-5 scores. At the 3-month follow-up, no statistically significant difference was observed between age groups. Finally, patients younger than 64 reported significantly less deterioration in post-operative erectile function. CONCLUSION Post-radical prostatectomy erectile dysfunction remains one of the most pressing issues in prostate cancer therapy. A higher Gleason score has a more significant impact on pre-operative ED, and at the same time, the best post-operative ED results are observed in younger patients. Finally, patients need extensive follow-up, therapy, and pre-and post-operative psychological support to have the best possible erectile function.
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Affiliation(s)
- Konstantinos Pikramenos
- Second Department of Urology, National and Kapodistrian University of Athens, Sismanoglio General Hospital, Athens, GRC
| | - Maria Zachou
- Gastroenterology, National and Kapodistrian University of Athens, Athens, GRC.,Gastroenterology, Sismanoglio General Hospital, Athens, GRC
| | - Dimitrios Papadopoulos
- Anaesthesiology, Evgenidio Hospital, National and Kapodistrian University of Athens, Athens, GRC
| | - Athanasios Papatsoris
- Second Department of Urology, National and Kapodistrian University of Athens, Sismanoglio General Hospital, Athens, GRC
| | - Ioannis Varkarakis
- Second Department of Urology, National and Kapodistrian University of Athens, Sismanoglio General Hospital, Athens, GRC
| | - Iraklis Mitsogiannis
- Second Department of Urology, National and Kapodistrian University of Athens, Sismanoglio General Hospital, Athens, GRC
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Yeh SJ, Chung YC, Chen BS. Investigating the Role of Obesity in Prostate Cancer and Identifying Biomarkers for Drug Discovery: Systems Biology and Deep Learning Approaches. MOLECULES (BASEL, SWITZERLAND) 2022; 27:molecules27030900. [PMID: 35164166 PMCID: PMC8840188 DOI: 10.3390/molecules27030900] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/22/2022] [Accepted: 01/26/2022] [Indexed: 12/21/2022]
Abstract
Prostate cancer (PCa) is the second most frequently diagnosed cancer for men and is viewed as the fifth leading cause of death worldwide. The body mass index (BMI) is taken as a vital criterion to elucidate the association between obesity and PCa. In this study, systematic methods are employed to investigate how obesity influences the noncutaneous malignancies of PCa. By comparing the core signaling pathways of lean and obese patients with PCa, we are able to investigate the relationships between obesity and pathogenic mechanisms and identify significant biomarkers as drug targets for drug discovery. Regarding drug design specifications, we take drug–target interaction, drug regulation ability, and drug toxicity into account. One deep neural network (DNN)-based drug–target interaction (DTI) model is trained in advance for predicting drug candidates based on the identified biomarkers. In terms of the application of the DNN-based DTI model and the consideration of drug design specifications, we suggest two potential multiple-molecule drugs to prevent PCa (covering lean and obese PCa) and obesity-specific PCa, respectively. The proposed multiple-molecule drugs (apigenin, digoxin, and orlistat) not only help to prevent PCa, suppressing malignant metastasis, but also result in lower production of fatty acids and cholesterol, especially for obesity-specific PCa.
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Porcaro AB, Cerrato C, Tafuri A, Bianchi A, Gallina S, Orlando R, Amigoni N, Rizzetto R, Gozzo A, Migliorini F, Zecchini Antoniolli S, Monaco C, Brunelli M, Cerruto MA, Antonelli A. Low endogenous testosterone levels are associated with the extend of lymphnodal invasion at radical prostatectomy and extended pelvic lymph node dissection. Int Urol Nephrol 2021; 53:2027-2039. [PMID: 34228260 PMCID: PMC8463355 DOI: 10.1007/s11255-021-02938-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 06/19/2021] [Indexed: 12/01/2022]
Abstract
Objective To investigate clinical factors associated to lymphnodal metastasis load in patients who underwent to radical prostatectomy (RP) and extended pelvic lymph node dissection (ePLND). Materials and methods Between November 2014 and December 2019, ET was measured in 617 consecutive patients not under androgen deprivation therapy who underwent RP and ePLND. Lymphnode invasion (LNI) was codified as not present (N = 0) or with one (N = 1) or more than one metastatic node (N > 1). The risk of multiple pelvic lymph node metastasis (N > 1, mPLNM) was assessed by comparing it to the other two groups (N > 1 vs. N = 0 and N > 1 vs. N = 1). Then, we assessed the association between ET and lymphnode invasion for standard predictors, such as PSA, percentage of biopsy positive cores (BPC), tumor stage greater than 1 (cT > 1) and tumor grade group greater than two (ISUP > 2). Results Overall, LNI was detected in 70 patients (11.3%) of whom 39 (6.3%) with N = 1 and 31 (5%) with N > 1. On multivariate analysis, ET was inversely associated with the risk of N > 1 when compared to both N = 0 (odds ratio, OR 0.997; CI 0.994–1; p = 0.027) as well as with N = 1 cases (OR 0.994; 95% CI 0.989–1.000; p = 0.015). Conclusions In clinical PCa, the risk of mPLNM was increased by low ET levels. As ET decreased, patients had an increased likelihood of mPLNM. Because of the inverse association between ET and mPLNM, higher ET levels were protective against aggressive disease. The influence of locally advanced PCa with high metastatic load on ET levels needs to be explored by controlled trials.
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Affiliation(s)
- Antonio Benito Porcaro
- Department of Urology, Ospedale Civile Maggiore, Polo Chirurgico Confortini, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Piazzale Stefani 1, 37126, Verona, Italy.
| | - Clara Cerrato
- Department of Urology, Ospedale Civile Maggiore, Polo Chirurgico Confortini, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Piazzale Stefani 1, 37126, Verona, Italy
| | - Alessandro Tafuri
- Department of Urology, Ospedale Civile Maggiore, Polo Chirurgico Confortini, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Piazzale Stefani 1, 37126, Verona, Italy.
- Department of Neuroscience, Imaging and Clinical Sciences, University G. D'Annunzio of Chieti-Pescara, Chieti, Italy.
| | - Alberto Bianchi
- Department of Urology, Ospedale Civile Maggiore, Polo Chirurgico Confortini, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Piazzale Stefani 1, 37126, Verona, Italy
| | - Sebastian Gallina
- Department of Urology, Ospedale Civile Maggiore, Polo Chirurgico Confortini, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Piazzale Stefani 1, 37126, Verona, Italy
| | - Rossella Orlando
- Department of Urology, Ospedale Civile Maggiore, Polo Chirurgico Confortini, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Piazzale Stefani 1, 37126, Verona, Italy
| | - Nelia Amigoni
- Department of Urology, Ospedale Civile Maggiore, Polo Chirurgico Confortini, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Piazzale Stefani 1, 37126, Verona, Italy
| | - Riccardo Rizzetto
- Department of Urology, Ospedale Civile Maggiore, Polo Chirurgico Confortini, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Piazzale Stefani 1, 37126, Verona, Italy
| | - Alessandra Gozzo
- Department of Urology, Ospedale Civile Maggiore, Polo Chirurgico Confortini, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Piazzale Stefani 1, 37126, Verona, Italy
| | - Filippo Migliorini
- Department of Urology, Ospedale Civile Maggiore, Polo Chirurgico Confortini, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Piazzale Stefani 1, 37126, Verona, Italy
| | - Stefano Zecchini Antoniolli
- Department of Urology, Ospedale Civile Maggiore, Polo Chirurgico Confortini, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Piazzale Stefani 1, 37126, Verona, Italy
| | - Carmelo Monaco
- Department of Urology, Ospedale Civile Maggiore, Polo Chirurgico Confortini, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Piazzale Stefani 1, 37126, Verona, Italy
| | - Matteo Brunelli
- Department of Pathology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Piazzale Stefani 1, 37126, Verona, Italy
| | - Maria Angela Cerruto
- Department of Urology, Ospedale Civile Maggiore, Polo Chirurgico Confortini, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Piazzale Stefani 1, 37126, Verona, Italy
| | - Alessandro Antonelli
- Department of Urology, Ospedale Civile Maggiore, Polo Chirurgico Confortini, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Piazzale Stefani 1, 37126, Verona, Italy
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Tafuri A, Sebben M, Pirozzi M, Processali T, Shakir A, Rizzetto R, Amigoni N, Brunelli M, Baccaglini W, Migliorini F, Siracusano S, Artibani W, Porcaro AB. Association between Basal Total Testosterone Levels and Prostate Cancer D'Amico Risk Classes. Urol Int 2020; 104:716-723. [PMID: 32460298 DOI: 10.1159/000506525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 02/13/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To test the hypothesis that basal total testosterone (TT) serum levels are associated with the D'Amico risk classification at diagnosis of prostate cancer (PCA). MATERIALS AND METHODS From November 2014 to March 2018, preoperative basal levels of TT and prostate-specific antigen (PSA) were measured in 601 consecutive PCA patients who were not under androgen deprivation therapy or undergoing prior prostate surgery. Patients were classified into low (reference group), intermediate, and high risk classes according to biopsy findings. The association of TT and other clinical factors with risk classes was evaluated using a multivariate multinomial logistic regression model. RESULTS According to the D'Amico classification, 124 patients (24%) were low risk, 316 (52.6%) were intermediate risk, and 141 (23.4%) were high risk. Median basal TT circulating levels were significantly increased along clinical risk classes. TT along with PSA, percentage of biopsy positive cores, and tumor clinical stage were independently associated with a high risk (OR = 1.002; p = 0.022) but not with an intermediate risk of PCA when compared to the low risk class. In the intermediate-risk group, endogenous TT together with PSA were independently associated with tumor grade groups 2 (OR = 1.003; p = 0.022) and 3 (OR = 1.003; p = 0.043) compared to grade group 1 cancers. CONCLUSIONS Basal TT levels are positively associated with the D'Amico risk classification, but the association is significant for the high-risk group compared to the low-risk group.
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Affiliation(s)
- Alessandro Tafuri
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy.,USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California (USC), Los Angeles, California, USA
| | - Marco Sebben
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Marco Pirozzi
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Tania Processali
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Aliasger Shakir
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California (USC), Los Angeles, California, USA
| | - Riccardo Rizzetto
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Nelia Amigoni
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Matteo Brunelli
- Department of Pathology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Willy Baccaglini
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California (USC), Los Angeles, California, USA.,Department of Pathology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy.,Departamento de Urologia, Faculdade de Medicina do ABC, São Paulo, Brazil
| | - Filippo Migliorini
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Salvatore Siracusano
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Walter Artibani
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Antonio Benito Porcaro
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy,
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Yassin A, Salman M, Talib RA, Yassin DJ. Is there a protective role of testosterone against high-grade prostate cancer? Incidence and severity of prostate cancer in 553 patients who underwent prostate biopsy: a prospective data register. Aging Male 2017; 20:125-133. [PMID: 28282997 DOI: 10.1080/13685538.2017.1298584] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
This study investigated the role of testosterone replacement therapy (TRT) in prostate safety and cancer progression. A cohort of 553 patients, 42 treated and 162 untreated hypogonadal men, and 349 eugonadal men were included. Pathological analysis of prostate biopsies examining the incidence and severity of PCa revealed that: 16.7% of treated hypogonadal men had a positive biopsy, a Gleason score of ≤6 in 71.4% and >6 in 28.6% of men, a predominant score of 3 and tumour staging of II in 85.7% men; 51.9% of untreated hypogonadal men had a positive biopsy, a Gleason score of ≤6 in 40.5% and >6 in 59.5% men, a predominant score of 3 (77.4%) and tumour staging of II (41.7%) or III (40.5%); 37.8% of eugonadal men had a positive biopsy, a Gleason score of ≤6 in 42.4% and >6 in 57.6% of men, a predominant score of 3 (82.6%) and tumour staging of II (44.7%) or III (47.7%). The incidence of positive prostate biopsies was lowest in hypogonadal men receiving TRT, with significantly lower severity of PCa in terms of staging and grading in the same group. These results suggest that TRT might have a protective effect against high-grade PCa.
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Affiliation(s)
- Aksam Yassin
- a Institute of Urology & Andrology , Norderstedt-Hamburg , Germany
- b Gulf Medical University , Ajman , UAE
- c Dresden International University , Dresden , Germany , and
| | - Mahmoud Salman
- a Institute of Urology & Andrology , Norderstedt-Hamburg , Germany
| | - Riadh A Talib
- d Department of Urology & Andrology , Hamad General Hospital , Doha , Qatar
| | - Dany-Jan Yassin
- a Institute of Urology & Andrology , Norderstedt-Hamburg , Germany
- b Gulf Medical University , Ajman , UAE
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Eisenberg ML. Testosterone Replacement Therapy and Prostate Cancer Incidence. World J Mens Health 2015; 33:125-9. [PMID: 26770932 PMCID: PMC4709428 DOI: 10.5534/wjmh.2015.33.3.125] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 10/16/2015] [Indexed: 11/25/2022] Open
Abstract
While early studies demonstrated a positive association between testosterone and prostate cancer, evidence on the nature of the relationship has evolved with time and newer data. Studies examining links between baseline testosterone levels as well as testosterone therapy and incident prostate cancer, reveal a more complex relationship. Moreover, investigators have reported their initial experiences with supplementing testosterone in men with a history of both treated and untreated prostate cancer.
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Affiliation(s)
- Michael Louis Eisenberg
- Departments of Urology, Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, USA
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9
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Pichon A, Neuzillet Y, Botto H, Raynaud JP, Radulescu C, Molinié V, Herve JM, Lebret T. Preoperative low serum testosterone is associated with high-grade prostate cancer and an increased Gleason score upgrading. Prostate Cancer Prostatic Dis 2015; 18:382-7. [PMID: 26439747 DOI: 10.1038/pcan.2015.44] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 08/06/2015] [Accepted: 08/25/2015] [Indexed: 01/06/2023]
Abstract
BACKGROUND To compare histological feature of prostate cancer (PCa) according androgenic status in patients who underwent radical prostatectomy (RP). METHODS Between March 2007 and September 2013, we prospectively analysed 937 patients who were referred to our centre for RP. Clinical, pathological and biological data have been prospectively collected. Preoperative total testosterone (TT) and bioavailable testosterone (BT) serum determinations were carried out. The threshold for low serum testosterone was set at TT<3 ng/ml. Preoperative PSA value was registered. Gleason score (GS) and predominant Gleason pattern were determined in prostate biopsies and in prostate tissue specimens, crosschecked by two uro-pathologists. RESULTS Nine hundred and thirty-seven consecutive patients were included. In all, 14.9% patients had low TT in the population. An exact match between biopsy and prostate specimens in GS grading was observed for 50.6% patients (n=474). Also, 40.9% of all patients were upgraded (n=383): 45.3% (n=63) in low serum testosterone patients and 40.1% (n=320) in normal serum testosterone patients. For prostate specimens, the proportion of patients with predominant Gleason pattern 4 was higher in patients with low TT compared with normal TT (41.7% vs 29.1%, P=0.0029). In all, 20.1% were upgraded from predominant Gleason pattern 3 on biopsies specimen to predominant Gleason 4 pattern on the prostate specimen in patients with low TT, whereas 11.6% were upgraded for normal TT patients (P=0.002). CONCLUSIONS Low serum testosterone is an independent risk factor for predominant Gleason pattern 4 on prostate specimen after RP and for upgrading from low- to high-grade cancer between prostate needle biopsies and RP specimen. This observation should be taken into account in localised PCa management, especially for active surveillance or when a nerve-sparing approach is considered.
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Affiliation(s)
- A Pichon
- Department of Urology, Foch Hospital, Suresnes, France
| | - Y Neuzillet
- Department of Urology, Foch Hospital, Suresnes, France
| | - H Botto
- Department of Urology, Foch Hospital, Suresnes, France
| | - J-P Raynaud
- Department of Physiology, University Pierre and Marie Curie, Paris, France
| | - C Radulescu
- Department of Pathology, Foch Hospital, Suresnes, France
| | - V Molinié
- Department of Pathology, CHU de Fort-de-France, Fort-de-France, France
| | - J-M Herve
- Department of Urology, Foch Hospital, Suresnes, France
| | - T Lebret
- Department of Urology, Foch Hospital, Suresnes, France
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10
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Jeong CW, Lee S, Jeong SJ, Hong SK, Byun SS, Lee SE. Preoperative erectile function and the pathologic features of prostate cancer. Int Braz J Urol 2015; 41:265-73. [PMID: 26005967 PMCID: PMC4752089 DOI: 10.1590/s1677-5538.ibju.2015.02.12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 06/08/2014] [Indexed: 11/24/2022] Open
Abstract
Purpose We evaluated whether preoperative erectile function is associated with pathologic features in the patients who underwent radical prostatectomy (RP). Materials and Methods We reviewed medical records of 1,743 men who underwent RP from November 2003 through May 2012. Of these, 50 patients who had prior hormone therapy and 272 patients who had lacking data of International Index of Erectile Function-5 (IIEF-5) were excluded. Men whose IIEF-5 was in the lower 25 percentile were assigned as Low Erectile Function group and the others were assigned as Control group. We compared pathologic features using univariable and multivariable logistic regression analysis between two groups. Results A total of 1,421 patients were included in the analysis. Patients’ age was 65.8 ± 6.7 years and prostate-specific antigen (PSA) was 12.8±16.1 ng/mL. Median and low 25 percentile of IIEF-5 were 14 and 8, respectively. Low Erectile Function group (IIEF-5<8) had higher risk to have high Gleason score (≥7(4+3), odds ratio (OR) 1.642, p<0.001) and large tumor volume (≥5 mL, OR 1.292, p=0.042). Even after adjusting age, year of surgery, body mass index, Charlson comorbidity index, PSA, clinical stage and biopsy Gleason score, Low Erectile Function group still had higher risk of high Gleason score (OR 1.910, p<0.001) and large tumor volume (OR 1.390, p=0.04) by multivariable logistic regressions. Conclusions Lower erectile function before RP was associated with higher Gleason’s score and larger tumor volume in final pathology. Thus, erectile function could be a surrogate barometer for prostate cancer aggressiveness.
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Affiliation(s)
- Chang Wook Jeong
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Urology, College of Medicine, Seoul National University, Seoul, Korea
| | - Sangchul Lee
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Urology, College of Medicine, Seoul National University, Seoul, Korea
| | - Seong Jin Jeong
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Urology, College of Medicine, Seoul National University, Seoul, Korea
| | - Sung Kyu Hong
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Urology, College of Medicine, Seoul National University, Seoul, Korea
| | - Seok-Soo Byun
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Urology, College of Medicine, Seoul National University, Seoul, Korea
| | - Sang Eun Lee
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Urology, College of Medicine, Seoul National University, Seoul, Korea
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11
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Low circulating free and bioavailable testosterone levels as predictors of high-grade tumors in patients undergoing radical prostatectomy for localized prostate cancer. Urol Oncol 2015; 33:384.e21-7. [DOI: 10.1016/j.urolonc.2014.11.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 10/28/2014] [Accepted: 11/17/2014] [Indexed: 11/18/2022]
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12
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The Relationship between Total Testosterone Levels and Prostate Cancer: A Review of the Continuing Controversy. J Urol 2015; 193:403-13. [DOI: 10.1016/j.juro.2014.07.123] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2014] [Indexed: 11/17/2022]
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