Predictive Value of Hormonal Evaluation Before Prostate Needle Biopsy on Prostate Cancer T Stage and Prognosis

Abstract

In this study we evaluated the hormone data before prostate needle biopsy (PNB) in patients who underwent retropubic radical prostatectomy (RRP) due to prostate adenocarcinoma (PCa). Correlations between the patients' RRP pathology results, recurrence-free survival (RFS), and hormone data were investigated. Materials and Methods: Patients were evaluated in two groups according to RRP pathologic T stage: T2 (group 1) and T3 (group 2). Then patients were assessed in two groups based on total testosterone (TTE) values: >300 ng/dL and <300 ng/dL. The preoperative data, hormone data, RRP pathologic data, and biochemical recurrence and RFS results were compared between these groups. Results: A total of 81 patients were evaluated. The mean follow-up time was 37.7 months. Mean recurrence free survival (RFS) among all patients was 94.2±7 months. In multivariate analysis of the preoperative data, TTE/prostate volume (p=0.015) and PNB tumor percentage (p=0.004) were significantly higher in group 2 (n=32) compared to group 1 (n=49). In the postoperative data, RRP pathology Gleason score (GS) (p=0.015) and tumor volume (p=0.02) were significantly higher in group 2. RFS was 99.2±5.8 months in group 1 and 77±12.1 months in group 2 (p=0.02). When patients were assessed according to TTE levels, of the pre-and postoperative data only RRP pathology T stage, GS, and lymph node positivity were significantly higher in the TTE <300 ng/dL group (n=30) compared to the TTE >300 ng/dL group (n=51). The biochemical recurrence rates and RFS times (87.7±13.8 months and 91.3±6.4 months, respectively) were similar between the groups (p=0.571). Conclusion: We demonstrated a correlation between locally invasive PCa and low TTE measured before PNB and low TTE density. In particular, TTE values <300 ng/dL were associated with high pathologic T stage, GS, and lymph node positivity.