Low serum testosterone levels are associated with positive surgical margins in radical retropubic prostatectomy: hypogonadism represents bad prognosis in prostate cancer.
OBJECTIVE
It has been reported that more aggressive prostate cancer (PC) can be associated with low serum testosterone levels. The relationship between serum androgens and PC is still not completely understood. In this study we examined the association of prognostic factors in men who underwent radical retropubic (RRP) prostatectomy with low or normal total testosterone.


METHODS
We retrospectively evaluated 64 consecutive patients with localized PC treated with RRP between July 2002 and November 2003. PC was diagnosed by transrectal ultrasonography guided biopsy performed for either a suspicious digital rectal examination or serum prostate specific antigen greater than 4.0 ng/ml. Gleason score was determined in prostatic biopsies. Pathological TNM staging (1997), capsular perforation, seminal vesicle involvement and surgical margin status were determined in all surgical specimens. The threshold for serum total testosterone was 270 ng/dl. In all analyses p <0.05 was considered statistically significant.


RESULTS
There were no statistically significant differences among prostate specific antigen, Gleason score (biopsy or specimen), pathological stage, capsular perforation and seminal vesicle involvement. However, patients with low total testosterone had increased positive surgical margins (p = 0.026).


CONCLUSIONS
Patients with low total testosterone more frequently present with positive surgical margins in RRP specimens. The true association between low testosterone and poor clinical outcome in the long term needs validation in large prospective studies.
Teloken
Claudio
C
Urology Department, Santa Casa Hospital, Porto Alegre, RS, Brazil 90450180.
Da Ros
Carlos Teodósio
CT
Caraver
Fernanda
F
Weber
Fernanda A
FA
Cavalheiro
Ana P
AP
Graziottin
Tulio Meyer
TM
D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D001706:Biopsy / Q000379:methods; D051517:Digital Rectal Examination; D006801:Humans; D007006:Hypogonadism / Q000097:blood* / Q000150:complications; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood* / Q000276:immunology / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D013739:Testosterone / Q000097:blood*; D016896:Treatment Outcome
D014408:Biomarkers, Tumor; D013739:Testosterone; D017430:Prostate-Specific Antigen