Low circulating free and bioavailable testosterone levels as predictors of high-grade tumors in patients undergoing radical prostatectomy for localized prostate cancer

Léon, Priscilla; Seisen, Thomas; Cussenot, Olivier; Drouin, S.; Cattarino, Susanna; Compérat, Eva; Renard-Penna, Raphaële; Mozer, Pierre; Bitker, Marc‐Olivier; Rouprêt, Morgan

doi:10.1016/j.urolonc.2014.11.010

Cited by 36 publications

(48 citation statements)

References 30 publications

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“…The present study demonstrated that, compared with high levels of total serum testosterone at the time of diagnosis, low total serum testosterone levels at the time of diagnosis were associated with aggressive features of PCa, which is consistent with the results of previous studies (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25). A previous pooled analysis of 18 prospective studies identified that pre-diagnosis serum testosterone levels were not associated with the high-risk form of PCa (32); however, the testosterone levels in this analysis were measured years prior to PCa diagnosis and a different definition of high-risk form of PCa was used.…”

Section: Discussionsupporting

confidence: 92%

“…However, studies on the association between testosterone and PCa risk have produced conflicting results (8,9). Numerous studies have demonstrated that low, rather than high, testosterone levels at diagnosis were associated with various markers of poor prognosis, including an advanced pathological stage, higher Gleason scores, higher PSA levels, seminal vesicle invasion and positive surgical margins (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25). Few studies have further investigated whether low levels of testosterone predict poor prognosis.…”

Section: Introductionmentioning

confidence: 99%

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Low serum testosterone is associated with tumor aggressiveness and poor prognosis in prostate cancer

Meng

et al. 2017

Oncology Letters

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Abstract. Serum testosterone is a potential marker to distinguish between indolent and aggressive prostate cancer (PCa). The present study aimed to investigate whether low levels of total serum testosterone at diagnosis were associated with aggressive PCa and poor clinical outcomes. In total, 762 non-Hispanic Caucasian men with previously untreated PCa were recruited from The University of Texas MD Anderson Cancer Center (Houston, TX, USA). Patients were categorized into three groups based on their total serum testosterone levels according to clinical guidelines [low (<230 ng/dl), intermediate (230-350 ng/dl) and normal (>350 ng/dl)]. PCa aggressiveness (low-, intermediate-or high-risk, or metastatic) was compared using multinomial logistic regression. Rates of disease progression, mortality from any cause and PCa-specific mortality were compared using the multivariate Cox proportional hazards model. Testosterone levels significantly decreased as PCa aggressiveness increased (P<0.001). Compared with the normal testosterone group, the low testosterone group had 2.9-fold (OR, 2.92; 95% CI, 1.74-4.90; P<0.001), 5.6-fold (OR, 5.63; 95% CI, 3.14-10.12; P<0.001) and 72.4-fold (OR, 72.40; 95% CI,; P<0.001) increased risks of having intermediate-risk, high-risk and metastatic PCa, respectively. Furthermore, low levels of testosterone were significantly associated with a 10.7-fold (HR, 10.68; 95% CI, 1.35-84.44; P= 0.03) increased risk of PCa-specific mortality. The results of the present study indicate that low levels of total serum testosterone at diagnosis are associated with aggressive PCa and predict poor PCa-specific survival.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Low serum testosterone is associated with tumor aggressiveness and poor prognosis in prostate cancer

Meng

et al. 2017

Oncology Letters

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“…49,50 To our knowledge, only one previously published study has demonstrated that low BT and FT levels were independent predictors of GS upgrading. 25 In our study, concordance was superior for patients with biochemical hypogonadism comparing with patients with normal TT (52.3% vs 39.6%, P = 0.1), and correlation coefficient was better for patients with normal TT than in patients with biochemical hypogonadism (0.5898 vs 0.4579; z = − 1.9689; P = 0.025). However, beyond the discordance between GS of biopsy and prostatectomy specimen, the upgrading from GS biopsy to GS prostate specimen is more relevant.…”

Section: Discussionmentioning

confidence: 42%

“…Several factors can influence the likelihood that prostate biopsy GS underestimates GS on prostate specimen, including PSA level, the level of pathologist expertise, patient's age, results of rectal digital examination, prostate volume, percentage of cancer cells in biopsy samples and the number of biopsies performed. [17][18][19][20][21][22][23][24] Léon et al 25 have shown that low bioavailable testosterone (BT) and free testosterone (FT) were independent predictors for pathological GS ⩾ 7 on prostate specimen after radical prostatectomy (RP) and were also predictive of GS upgrading from low-to high-grade disease.…”

Section: Introductionmentioning

confidence: 99%

Preoperative low serum testosterone is associated with high-grade prostate cancer and an increased Gleason score upgrading

Pichon

Neuzillet

Botto

et al. 2015

Prostate Cancer Prostatic Dis

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“…Distintos estudios afirman que bajos niveles de testosterona libre y biodisponible circulantes se relacionan con alto grado de cán-cer de próstata, por tanto mayor riesgo al padecer la enfermedad (9). Otros autores como Kayali et al (10) afirman que la presencia de hipogonadismo del adulto aumenta el riesgo de cáncer de próstata y la agresividad del mismo.…”

Section: Discussionunclassified

Hormonal study in patients with prostate cancer with PSA at diagnosis between 4-10 ng/ml and PSA free/total <20%

Amillo¹,

García²,

Convalía³

et al. 2015

Actual. Med.

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Estudio hormonal en pacientes con cáncer de próstata con PSA al diagnóstico entre 4-10 ng/ml y cociente libre/total <20% Resumen Objetivo: El objetivo de este estudio es analizar los parámetros hormonales en pacientes con adenocarcinoma de próstata con PSA entre 4-10 ng/ml (cociente libre/total <20%) en el momento del diagnóstico. Material y Métodos: Desde enero a diciembre de 2014, se incluyen en este estudio hombres con PSA entre 4-10 ng/ ml y cociente libre/total <20%, candidatos a biopsia de próstata. Se excluyen del estudio pacientes que estén tomando inhibidores de la 5 alfa-reductasa y pacientes con biopsias de próstata previamente realizadas. Se analiza edad, PSA total, testosterona total, libre y biodisponible, FSH, LH, SHBG, 17-hidroxiprogesterona, Androstendiona, volumen prostático (medido por ecografía transrectal), cocientes testosterona total/PSA, testosterona libre/PSA, testosterona biodisponible/PSA y Densidad de PSA, testosterona total/volumen próstata, testosterona libre/volumen próstata y testosterona biodisponible/volumen próstata. Análisis estadístico con SPSS 20.0 y significación estadística p≤0.05. Resultados: Un total de 109 pacientes han sido incluídos, sólo el 44.9% de los mismos presenta adenocarcinoma de próstata en la biopsia, incluyéndose en este estudio. Destaca un volumen prostático de 37.6 cc, una densidad PSA de 0.24, unos niveles de testosterona total de 4.51 ng/ml, de testosterona libre de 0.076 ng/ml y de testosterona biodisponible de 1.94 ng/ml. Además es destacable un cociente testosterona total/volumen próstata de 0.15, testosterona libre/volumen próstata de 0.002 y testosterona biodisponible/volumen próstata de 0.06. Existe relación lineal positiva y significativa entre niveles de PSA y grado de Gleason y entre SHBG y grado de Gleason. Además se observa relación lineal negativa y significativa entre el volumen de próstata y el ratio testosterona/PSA. Conclusión: Los niveles de PSA y SHBG se asocian con un mayor gleason de la biopsia y por tanto con un mayor riesgo histológico.

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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

Cited by 36 publications

References 30 publications

Low serum testosterone is associated with tumor aggressiveness and poor prognosis in prostate cancer

Low serum testosterone is associated with tumor aggressiveness and poor prognosis in prostate cancer

Preoperative low serum testosterone is associated with high-grade prostate cancer and an increased Gleason score upgrading

Hormonal study in patients with prostate cancer with PSA at diagnosis between 4-10 ng/ml and PSA free/total <20%

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