Circulating free testosterone is an independent predictor of advanced disease in patients with clinically localized prostate cancer

Abstract

Low pre-treatment fT levels were significantly associated with tumour stage and extraprostatic tumour spread and might-in addition or combination with PSA-serve as a useful prognostic parameter for prostate cancer patients prior to radical prostatectomy.

Serum 17β-estradiol fails as a marker in identification of aggressive tumour disease in patients with localized prostate cancer

“…In addition, obese patients presented more often with higher pathological tumour stage (p = 0.027, Chi-square). Similar results were found for patients with a WC > 110 cm who also suffered significantly more often from aggressive PC (Gleason score ≥ 8 vs. [2][3][4][5][6][7]19.0 vs. 10.7 %, p = 0.006, Fisher's exact), nodal metastasis (12.5 vs. 7.2 %, p = 0.039, Fishers' exact), and-by tendency-higher tumour stages (p = 0.12, Chi-square). However, the surgical margin status did not correlate with a high BMI or large WC.…”

“…Ever since, there are controversies in the literature about the relationship between both high and low sex hormone serum levels, such as testosterone or estradiol and their involvement in the formation of aggressive localized PC [6,18].…”

“…Although controversies exist [4,5], one putative mechanism explaining the association between obesity and aggressive PC is the low testosterone environment in obese men [6]. Due to the fact that testosterone is aromatized to estradiol within adipocytes and prostate cells, various preclinical studies support the assumption that oestrogen plays an important role in PC development and progression [7][8][9].…”

Prediagnostic Body Mass Index Trajectories in Relation to Prostate Cancer Incidence and Mortality in the PLCO Cancer Screening Trial

“…Obese men have been shown to exhibit reduced levels of androgens (51), and there is evidence that men with lower levels of testosterone have more aggressive tumors at clinical presentation (52,53). The influence of early-life exposures is suspected to be important in prostate cancer etiology (13) as carcinogenic processes have been seen within prostatic tissue in men in their 20s (14).…”

Androgen annihilation as a new therapeutic paradigm in advanced prostate cancer

“…After initiation of hormone therapy, however, serum testosterone and intraprostatic levels of DHT have been shown to become positively correlated [10]. Interestingly, two recent studies [11,12] have found a positive correlation between percentage-free testosterone (measured as free testosterone/total testosterone) and high-grade features on either biopsy or final prostatectomy.…”