title: Preoperative sex steroids are significant predictors of early biochemical recurrence after radical prostatectomy.
abstract: OBJECTIVE
  We sought the association of preoperative serum total testosterone (tT), hypogonadism, 17β estradiol (E2), and sex hormone-binding globulin (SHBG) with early biochemical recurrence (BCR) after radical prostatectomy (RP).
  
  
  METHODS
  Sex steroids were assessed the day before surgery (7-11 a.m.) in a cohort of 605 patients with a median follow-up of 24 months following RP. Cox regression models tested the association between predictors [including age, body mass index (BMI), prostate-specific antigen (PSA), clinical stage, biopsy Gleason scores, tT, hypogonadism, E2, and SHBG] and early BCR (defined as a PSA ≥ 0.1 ng/ml that occurred within 24 months after RP).
  
  
  RESULTS
  Early BCR was found in 34 (5.6 %) patients. Patients with BCR did not differ in terms of age, BMI, serum PSA, tT, E2, and SHBG levels, rate of hypogonadism, and clinical stage as compared with those without BCR (all p ≥ 0.05). Conversely, patients with BCR showed a greater prevalence of biopsy Gleason scores ≥4 + 3 (all p ≤ 0.001). At multivariable Cox regression analysis, tT [hazard ratio (HR): 1.43; p = 0.03] E2 (HR: 1.05; p = 0.04), SHBG (HR: 1.29; p = 0.02), and biopsy Gleason scores equal to 4 + 3 (HR: 3.37; p = 0.04) and ≥8 (HR: 20.06; p < 0.001) achieved independent predictor status for early BCR. Conversely, no significant associations were found for all the other predictors.
  
  
  CONCLUSIONS
  Current findings show that preoperative serum sex steroids are independent predictors of early BCR in a homogeneous, large cohort of nonscreened patients treated with RP.
authors.affiliation: Department of Urology, University Vita-Salute San Raffaele, Via Olgettina 60, 20132, Milan, Italy. salonia.andrea@hsr.it
authors.forename: Andrea
authors.initials: A
authors.lastname: Salonia
authors.forename: Firas
authors.initials: F
authors.lastname: Abdollah
authors.forename: Umberto
authors.initials: U
authors.lastname: Capitanio
authors.forename: Andrea
authors.initials: A
authors.lastname: Gallina
authors.forename: Nazareno
authors.initials: N
authors.lastname: Suardi
authors.forename: Alberto
authors.initials: A
authors.lastname: Briganti
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Zanni
authors.forename: Matteo
authors.initials: M
authors.lastname: Ferrari
authors.forename: Fabio
authors.initials: F
authors.lastname: Castiglione
authors.forename: Maria Chiara
authors.initials: MC
authors.lastname: Clementi
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; D015331:Cohort Studies; D018572:Disease-Free Survival; D004958:Estradiol / Q000097:blood*; D006801:Humans; D007006:Hypogonadism / Q000097:blood / Q000150:complications; D007610:Kallikreins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood*; D011379:Prognosis; D016016:Proportional Hazards Models; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood* / Q000150:complications / Q000601:surgery; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism*; D013739:Testosterone / Q000097:blood*
chemical_list: D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D004958:Estradiol; C549870:KLK3 protein, human; D007610:Kallikreins; D017430:Prostate-Specific Antigen