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Abstract

Volume 18, Issue 1 (January 2016) 18, 54–59; 10.4103/1008-682X.154317

Effect of serum testosterone and percent tumor volume on extra-prostatic extension and biochemical recurrence after laparoscopic radical prostatectomy

Eu Chang Hwang1, Seong Hyeon Yu1, Yang Hyun Jo1, Seung Il Jung1, Taek Won Kang1, Dong Deuk Kwon1, Chan Choi2, Suk Hee Heo3, Jun Eul Hwang4, Sung-Hoon Jung4, Tae-Young Jung5

1 Department of Urology, Chonnam National University Medical School, Gwangju, Republic of Korea
2 Department of Pathology, Chonnam National University Medical School, Gwangju, Republic of Korea
3 Department of Radiology, Chonnam National University Medical School, Gwangju, Republic of Korea
4 Department of Hemato oncology, Chonnam National University Medical School, Gwangju, Republic of Korea
5 Department of Neurosurgery, Chonnam National University Medical School, Gwangju, Republic of Korea

Correspondence: Dr. DD Kwon (urokwon@gmail.com, urohwang@naver.com)

05-May-2015

Abstract

Abstract

Several studies have revealed that the preoperative serum testosterone and percent tumor volume (PTV) predict extra-prostatic extension (EPE) and biochemical recurrence (BCR) after radical prostatectomy. This study investigated the prognostic significance of serum testosterone and PTV in relation to EPE and BCR after laparoscopic radical prostatectomy (LRP). We reviewed 520 patients who underwent LRP between 2004 and 2012. PTV was determined as the sum of all visually estimated tumor foci in every section. BCR was defined as two consecutive increases in the postoperative prostate-specific antigen (PSA) >0.2 ng ml−1 . The threshold for serum total testosterone was 3.0 ng ml−1 . Multivariate logistic regression was used to define the effect of variables on the risk of EPE and BCR. A low serum testosterone (<3.0 ng ml−1 ) was associated with a high serum PSA, Gleason score, positive core percentage of the prostate biopsy, PTV, and all pathological variables. On multivariate analysis, similar to previous studies, the serum PSA, biopsy positive core percentage, Gleason score, and pathological variables predicted EPE and BCR. In addition, low serum testosterone (<3.0 ng ml−1 , adjusted OR, 8.52; 95% CI, 5.04-14.4, P= 0.001) predicted EPE and PTV (adjusted OR, 1.02; 95% CI, 1.01-1.05, P= 0.046) predicted BCR. In addition to previous predictors of EPE and BCR, low serum testosterone and PTV are valuable predictors of EPE and BCR after LRP.

Keywords: biochemical recurrence; extra-prostatic extension; prostate neoplasms; prostatectomy; testosterone; tumor burden

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