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

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...

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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:	Online
Language:	English
Published:	Medknow Publications & Media Pvt Ltd 2016
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4955193/

id	pubmed-4955193
recordtype	oai_dc
spelling	pubmed-49551932016-07-26 Low serum testosterone predicts upgrading and upstaging of prostate cancer after radical prostatectomy 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 Original Article 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 RP. 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. Medknow Publications & Media Pvt Ltd 2016 2015-12-29 /pmc/articles/PMC4955193/ /pubmed/26732103 http://dx.doi.org/10.4103/1008-682X.169984 Text en Copyright: © Asian Journal of Andrology http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	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
spellingShingle	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 Low serum testosterone predicts upgrading and upstaging of prostate cancer after radical prostatectomy
author_facet	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
author_sort	Gao, Yuan
title	Low serum testosterone predicts upgrading and upstaging of prostate cancer after radical prostatectomy
title_short	Low serum testosterone predicts upgrading and upstaging of prostate cancer after radical prostatectomy
title_full	Low serum testosterone predicts upgrading and upstaging of prostate cancer after radical prostatectomy
title_fullStr	Low serum testosterone predicts upgrading and upstaging of prostate cancer after radical prostatectomy
title_full_unstemmed	Low serum testosterone predicts upgrading and upstaging of prostate cancer after radical prostatectomy
title_sort	low serum testosterone predicts upgrading and upstaging of prostate cancer after radical prostatectomy
description	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 RP. 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.
publisher	Medknow Publications & Media Pvt Ltd
publishDate	2016
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4955193/
_version_	1613612730659373056

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

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