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Abstract

Volume 24, Issue 1 (January 2022) 24, 21–25; 10.4103/aja.aja_58_21

Follicle-stimulating hormone (FSH) levels prior to prostatectomy are not related to long-term oncologic or cardiovascular outcomes for men with prostate cancer

Kassim Kourbanhoussen1, France-Hélène Joncas1, Christopher J D Wallis2, Hélène Hovington1, François Dagenais3, Yves Fradet1, Chantal Guillemette4, Louis Lacombe1, Paul Toren1

1 Department of Surgery, Faculty of Medicine, Universitè Laval, CHU de Quèbec Research Center, Oncology Division, Quebec City G1R3S1, Canada
2 Department of Urology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
3 Institut Universitaire Cardiologie et Pneumologie de Quèbec, Quebec City G1V 4G5, Canada
4 Faculty of Pharmacy, Universitè Laval, CHU de Quèbec Research Center, Quebec City G1V 4G2, Canada

Correspondence: Dr. P Toren (paul.toren@crchudequebec.ulaval.ca)

Date of Submission 27-Dec-2020 Date of Acceptance 13-Apr-2021 Date of Web Publication 09-Jul-2021

Abstract

Prior research suggests a link between circulating levels of follicle-stimulating hormone (FSH) and prostate cancer outcomes. FSH levels may also explain some of the observed differences in cardiovascular events among men treated with gonadotropin-releasing hormone (GnRH) antagonists compared to GnRH agonists. This study evaluates the association between preoperative FSH and long-term cardiovascular and oncologic outcomes in a cohort of men with long follow-up after radical prostatectomy. We performed a cohort study utilizing an institutional biobank with annotated clinical data. FSH levels were measured from cryopreserved plasma and compared with sex steroids previously measured from the same samples. Differences in oncologic outcomes between tertiles of FSH levels were compared using adjusted cox regression models. Major adverse cardiovascular events (MACE) were similarly assessed using hospital admission diagnostic codes. A total of 492 patients were included, with a median follow-up of 13.1 (interquartile range: 8.9–15.9) years. Dehydroepiandrosterone sulfate (DHEA-S) levels, but not other androgens, negatively correlated with FSH levels on linear regression analysis (P = 0.03). There was no association between FSH tertile and outcomes of biochemical recurrence, time to castrate-resistant prostate cancer, or time to metastasis. MACEs were identified in 50 patients (10.2%), with a mean time to first event of 8.8 years. No association with FSH tertile and occurrence of MACE was identified. Our results do not suggest that preoperative FSH levels are significantly associated with oncologic outcomes among prostate cancer patients treated with radical prostatectomy, nor do these levels appear to be predictors of long-term cardiovascular risk.

Keywords: cardiovascular events; follicle-stimulating hormone; prostate cancer; recurrence

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