Low serum testosterone predicts upgrading and upstaging of prostate cancer after radical prostatectomy

• Published in: Asian journal of andrology Vol. 18; no. 4; pp. 639 - 643
• Main Authors: Gao, Yuan, Jiang, Chen-Yi, Mao, Shi-Kui, Cui, Di, Hao, Kui-Yuan, Zhao, Wei, Jiang, Qi, Ruan, Yuan, Xia, Shu-Jie, Han, Bang-Min
• Format: Journal Article
• Language: English
• Published: China Wolters Kluwer - Medknow Publications 01.07.2016; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Medknow Publications & Media Pvt Ltd; Wolters Kluwer Medknow Publications
• Subjects: Age; Aged; Androgens; Body mass index; Complications and side effects; Humans; Logistic回归分析; Lymphatic system; Male; Measurement; Middle Aged; Neoplasm Grading; Neoplasm Staging; Original; Prognosis; Prostate - pathology; Prostate - surgery; Prostate cancer; Prostate-Specific Antigen - blood; Prostatectomy; Prostatectomy - methods; Prostatic Neoplasms - blood; Prostatic Neoplasms - pathology; Prostatic Neoplasms - surgery; prostatic neoplasms; radical prostatectomy; serum total testosterone; Retrospective Studies; Score; Studies; Surgery; Testosterone; Testosterone - blood; 临床表现; 切除术; 前列腺癌; 特异性抗原; 血清睾酮; 预测因子
• ISSN: 1008-682X; 1745-7262
• DOI: 10.4103/1008-682X.169984

Often, pathological Gleason Score （GS） and stage of prostate cancer （PCa） were inconsistent with biopsy GS and clinical stage.However, there were no widely accepted methods predicting upgrading and upstaging PCa. In our study, we investigated the association between serum testosterone and upgrading or upstaging of PCa after radical prostatectomy （RP）. We enrolled 167 patients with PCa with biopsy GS 〈6, clinical stage ≤T2c, and prostate-specific antigen （PSA） 〈10 ng ml-1 from April 2009 to April 2015. Data including age, body mass index, preoperative PSA level, comorbidity, clinical presentation, and preoperative serum total testosterone level were collected. Upgrading occurred in 62 （37.1%） patients, and upstaging occurred in 73 （43.7%） patients. Preoperative testosterone was lower in the upgrading than nonupgrading group （3.72 vs 4.56, P 〈 0.01）. Patients in the upstaging groUp had lower preoperative testosterone than those in the nonupstaging group （3.84 vs 4.57, P = 0.01）. In multivariate logistic regression analysis, as both continuous and categorical variables, low serum testosterone was confirmed to be an independent predictor of pathological upgrading （P = 0.01 and P = 0.01） and upstaging （P = 0.01 and P = 0.02） after RR We suggest that low serum testosterone （〈3 ng ml-1） is associated with a high rate of upgrading and upstaging after RP. It is better for surgeons to ensure close monitoring of PSA levels and imaging examination when selecting non-RP treatment, to be cautious in proceeding with nerve-sparing surgery, and to be enthusiastic in performing extended lymph node dissection when selecting RP treatment for patients with low serum testosterone.