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Association of 5α‐reductase inhibitor use and pathological features of prostate cancer in men undergoing radical prostatectomy
Author(s) -
Hong Sung Kyu,
Oh Jong Jin,
Lee Sangchul,
Lee Hak Min,
Byun SeokSoo,
Choe Gheeyoung,
Lee Sang Eun
Publication year - 2011
Publication title -
the prostate
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.295
H-Index - 123
eISSN - 1097-0045
pISSN - 0270-4137
DOI - 10.1002/pros.22468
Subject(s) - prostatectomy , medicine , prostate cancer , urology , biochemical recurrence , prostate , prostate specific antigen , proportional hazards model , stage (stratigraphy) , oncology , cancer , paleontology , biology
BACKGROUND We investigated the association of 5α‐reductase inhibitor (5‐ARI) treatment with pathologic and biochemical outcome among the contemporary prostate cancer (PCa) patients undergoing radical prostatectomy. METHODS We reviewed records of 1,204 men who underwent radical prostatectomy from 2003 to 2010. We estimated association of 5‐ARI use with high (≥7) pathologic Gleason score and pathologically nonorgan‐confined disease (≥pT3) via logistic regression, and biochemical outcome via Cox proportional hazards regression. RESULTS Of 1,204 patients, 50 (4.2%) reported having history 5‐ARI treatment before radical prostatectomy. Median duration of 5‐ARI treatment among the 50 patients was 23.0 months. When adjusted for various factors including age, body mass index, prostate‐specific antigen, clinical stage, biopsy Gleason, and prostate volume, history of 5‐ARI treatment was revealed to be significantly associated with high (≥7) pathologic Gleason score ( P = 0.015). Also, 5‐ARI use was observed to significantly associated with higher rates of extraprostatic extension of tumor ( P = 0.005) and seminal vesicle invasion ( P = 0.003), respectively, when adjusted for same variables. However, 5‐ARI use was not demonstrated to be a significant preoperative predictor of biochemical recurrence‐free survival in multivariate analysis ( P = 0.528). CONCLUSIONS Our results showed 5‐ARI treatment may be associated with more aggressive PCa demonstrating higher pathologic Gleason score and advanced pathologic tumor stage in men undergoing radical prostatectomy. However, further investigations via larger‐scale, prospective studies would be needed on the actual effect of 5‐ARI treatment on PCa‐specific morbidity and mortality. Prostate 72:1187–1192, 2012. © 2011 Wiley Periodicals, Inc.