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Abstract

Volume 18, Issue 4 (July 2016) 18, 639–643; DOI:10.4103/1008-682X.169984

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

Yuan Gao, Chen-Yi Jiang, Shi-Kui Mao, Di Cui, Kui-Yuan Hao, Wei Zhao, Qi Jiang, Yuan Ruan, Shu-Jie Xia, Bang-Min Han

Department of Urology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China.

Correspondence: Dr. BM Han (hanbm@163.com)

Received: 16 July 2015; Revised: 24 August 2015; Accepted: 30 October 2015

Abstract

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.

Full Text | PDF | 中文摘要 |

 
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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.