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Serum testosterone level as a predictor of biochemical failure after radical prostatectomy for localized prostate cancer
Author(s) -
Røder Martin Andreas,
Christensen Ib Jarle,
Berg Kasper D.,
Gruschy Lisa,
Brasso Klaus,
Iversen Peter
Publication year - 2012
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2011.10335.x
Subject(s) - prostatectomy , prostate cancer , testosterone (patch) , medicine , urology , prostate , oncology , cancer
Study Type – Aetiology (individual cohort) Level of Evidence 2b What’s known on the subject? and What does the study add? The precise relationship between serum testosterone (T) and prostate cancer (PCa) incidence and progression is controversial. Low pre‐treatment serum T correlates with higher risk of BF after radical prostatectomy, and T may possess biological information about PCa progression potential. OBJECTIVE • To investigate serum testosterone levels as a predictor for biochemical failure (BF) after radical retropubic prostatectomy (RRP). PATIENTS AND METHODS • Prospective cohort study with 227 patients and a median follow‐up of 7.7 years. • Total serum testosterone was measured at diagnosis. • Primary endpoint: 5‐year BF‐free survival defined as first PSA > 0.2 ng/mL. • Testosterone was tested as a predictor of BF as a dichotomized and continuous variable. RESULTS • Median (range) age was 62 years (45–74), median PSA 9.9 ng/mL (0.4–96), and median testosterone was 14 nmol/L (2.2–40). • BF occurred for 57 patients (26%) within 5 years. • In multivariate analysis with age, PSA, and biopsy Gleason score, testosterone levels >11 nmol/L were an independent predictor for reduced risk of BF (hazard ratio, 0.53; 95% confidence interval, 0.31–0.90; P = 0.02). • When analyzed as a continuous variable, testosterone was not a statistically significant predictor of BF. CONCLUSION • Low pretreatment serum testosterone levels correlate with a higher risk of BF, and testosterone may possess biological information about prostate cancer progression potential, which makes it an independent predictor of biochemical failure after RRP.