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Abstract

Volume 17, Issue 1 (January 2015) 17, 98–105; 10.4103/1008-682X.136445

Estrogen receptor (α and β) but not androgen receptor expression is correlated with recurrence, progression and survival in post-prostatectomy T3N0M0 locally advanced prostate cancer in an urban Greek population

Georgios Megas,1 Michael Chrisofos,2 Ioannis Anastasiou,3 Aida Tsitlidou,4 Theodosia Choreftaki,4 Charalampos Deliveliotis5

1General Hospital of Athens ‘‘G. Gennimatas’’, Urology Department, Greece
2Athens Medical school, 2nd Department of Urology ‘‘Attiko’’ Hospital, Athens, Greece
3Athens Medical school, 1st Department of Urology, ‘‘Laiko’’ Hospital, Athens, Greece
4General Hospital of Athens ‘‘G. Gennimatas’’, Pathology Department, Greece
5Athens Medical school, 2ndDepartment of Urology, ‘‘Sismanoglio’’ Hospital, Athens, Greece

Correspondence: Dr. G Megas (megaskgeorgios@yahoo.gr)

Received: 22 November 2013; Revised: 26 January 2014; Accepted: 23 April 2014

Abstract

The objective of this study was to evaluate the expression of estrogen receptors (ER(α) and ER(β)) and androgen receptors (ARs) as prognostic factors for biochemical recurrence, disease progression and survival in patients with pT3N0M0 prostate cancer (PCa) in an urban Greek population. A total of 100 consecutive patients with pT3N0M0 PCa treated with radical prostatectomy participated in the study. The mean age and follow-up were 64.2 and 6 years, respectively. The HSCORE was used for semi-quantitative analysis of the immunoreactivity of the receptors. The prognostic value of the ER(α) and ER(β) and AR was assessed in terms of recurrence, progression, and survival. AR expression was not associated with any of the above parameters; however, both ERs correlated with the prognosis. A univariate Cox regression analysis showed that ER(α) positive staining was significantly associated with a greater hazard for all outcomes. Increased ER(β) staining was significantly associated with a lower hazard for all outcomes in the univariate analysis. When both ER HSCORES were used for the analysis, it was found that patients with high ER(α) or low ER(β) HSCORES compared with patients with negatively stained ER(α) and >1.7 hSCORE ER(β) had 6.03, 10.93, and 10.53 times greater hazard for biochemical disease recurrence, progression of disease and death, respectively. Multiple Cox proportional hazard analyses showed that the age, preoperative prostate specific antigen, Gleason score and ERs were independent predictors of all outcomes. ER expression is an important prognosticator after radical prostatectomy in patients with pT3N0M0 PCa. By contrast, AR expression has limited prognostic value.

Keywords: androgen receptor; estrogen receptor (α); estrogen receptor (β); locally advanced prostate cancer; radical prostatectomy

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Asian Journal of Andrology CN 31-1795/R ISSN 1008-682X  Copyright © 2023  Shanghai Materia Medica, Chinese Academy of Sciences.  All rights reserved.