Endogenous testosterone mirrors prostate cancer aggressiveness: correlation between basal testosterone serum levels and
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UROLOGY - ORIGINAL PAPER
Endogenous testosterone mirrors prostate cancer aggressiveness: correlation between basal testosterone serum levels and prostate cancer European Urology Association clinical risk classes in a large cohort of Caucasian patients Alessandro Tafuri1,2 · Marco Sebben1 · Aliasger Shakir2 · Marco Pirozzi1 · Tania Processali1 · Riccardo Rizzetto1 · Nelia Amigoni1 · Matteo Brunelli3 · Filippo Migliorini1 · Salvatore Siracusano1 · Maria Angela Cerruto1 · Walter Artibani1 · Alessandro Antonelli1 · Antonio B. Porcaro1 Received: 19 November 2019 / Accepted: 27 January 2020 © Springer Nature B.V. 2020
Abstract Objective To evaluate the association between basal total testosterone (TT) levels with the European Association of Urology (EAU) risk classes at the time of diagnosis of prostate cancer (PCA). Methods A retrospective review of prospectively collected data was carried out between November 2014 and March 2018. Preoperative basal TT levels and PSA were measured in 601 consecutive Caucasian patients who were not under androgen deprivation and undergoing surgery at a tertiary referral center. Patients were classified into low (reference group), intermediate- and high-risk/locally advanced classes. The multinomial logistic regression model evaluated associations of TT and other clinical factors with EAU risk classes. Results One hundred twenty four patients (24%) were low risk, 316 (52.6%) were intermediate, 199 (16.5%) were high risk and 42 (7%) were locally advanced. Median circulating basal TT levels increased along EAU classes. TT, PSA, percentage of biopsy-positive cores and tumor clinical stage were independently associated with the high-risk class (odds ratio, OR = 1.002; p = 0.030) but were not associated with intermediate-risk or locally advanced PCA when compared to the low-risk class. TT above the median value was an independent predictor of high-risk class PCA. Conclusions Basal TT levels are positively associated with low, intermediate and high EAU risk classes. The association is significant for the high-risk class when compared to the low-risk group, but was lost in locally advanced risk class. In PCA patients, high TT serum levels are associated with high-risk disease. Endogenous TT should be considered as a biological marker for assessing EAU PCA risk classes. Keywords Prostate cancer · EAU risk classes · Tumor grade group · Radical prostatectomy · Total testosterone
Introduction Alessandro Tafuri and Marco Sebben authors contributed equally to this manuscript. * Antonio B. Porcaro [email protected] 1
Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Piazzale Stefani 1, 37126 Verona, Italy
2
USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA
3
Department of Pathology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
The association between testosterone and prosta
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