title: Preoperative circulating sex hormones are not predictors of positive surgical margins at open radical prostatectomy.
abstract: OBJECTIVE
  To examine the association between positive surgical margins (PSMs) and preoperative circulating estradiol (E(2)), total testosterone (tT), and sex hormone-binding globulin (SHBG) in patients undergoing retropubic radical prostatectomy (RRP).
  
  
  METHODS
  A cohort of 665 non-screened patients who underwent RRP at a single institute was studied. Serum tT, E(2), and SHBG were measured the day before surgery (8-10 AM: ) in all cases. Logistic regression models tested the association between predictors [e.g., PSA, clinical stage, biopsy Gleason sum, body mass index (BMI), tT, E(2), and SHBG] and PSM. Circulating tT was included in the model as both a continuous variable and a categorized variable [according to the definition of hypogonadism (<3 ng/ml)].
  
  
  RESULTS
  PSMs were found in 175 patients (26.3%) within the whole cohort of men and in 78 (16.2%) of the pT2 patients. Patients with PSMs had significantly higher PSA, a higher proportion of more advanced clinical stage, and a lower rate of well-differentiated biopsy Gleason sum than those without PSMs (all P ≤ 0.03). Conversely, no significant differences were found regarding age, BMI, preoperative tT, E(2), and SHBG between patients with and without PSMs. At multivariate analysis, tT, hypogonadism, E(2), and SHBG were not significantly associated with PSMs, after accounting for routinely available preoperative parameters.
  
  
  CONCLUSIONS
  In contrast to previously published data, preoperative tT was not an independent predictive factor for PSM at RRP. Likewise, hypogonadism, E(2), and SHBG did not achieve independent predictor status for PSM, after accounting for routinely available preoperative parameters.
authors.affiliation: Department of Urology, University Vita-Salute San Raffaele, Via Olgettina 60, Milan, Italy. salonia.andrea@hsr.it
authors.forename: Andrea
authors.initials: A
authors.lastname: Salonia
authors.forename: Andrea
authors.initials: A
authors.lastname: Gallina
authors.forename: Firas
authors.initials: F
authors.lastname: Abdollah
authors.forename: Alberto
authors.initials: A
authors.lastname: Briganti
authors.forename: Umberto
authors.initials: U
authors.lastname: Capitanio
authors.forename: Nazareno
authors.initials: N
authors.lastname: Suardi
authors.forename: Matteo
authors.initials: M
authors.lastname: Ferrari
authors.forename: Marco
authors.initials: M
authors.lastname: Raber
authors.forename: Renzo
authors.initials: R
authors.lastname: Colombo
authors.forename: Massimo
authors.initials: M
authors.lastname: Freschi
authors.forename: Patrizio
authors.initials: P
authors.lastname: Rigatti
authors.forename: Francesco
authors.initials: F
authors.lastname: Montorsi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D001706:Biopsy; D015331:Cohort Studies; D004958:Estradiol / Q000097:blood*; D006801:Humans; D007006:Hypogonadism / Q000473:pathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D057234:Preoperative Period; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism*; D013739:Testosterone / Q000097:blood*
chemical_list: D014408:Biomarkers, Tumor; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D004958:Estradiol