title: Preoperative Serum Sex Hormone-Binding Globulin Level Is an Independent Predictor of Biochemical Outcome After Radical Prostatectomy.
abstract: To investigate the significance of preoperative serum sex hormone-binding globulin (SHBG) level regarding the postoperative biochemical outcome in patients who were followed up for relative longer periods after undergoing radical prostatectomy (RP). Preoperative serum levels of testosterone (T), free T, and SHBG level were prospectively analyzed in 307 consecutive patients who underwent RP at our institution between January 2006 and July 2007. We analyzed potential associations of sex hormones with postoperative biochemical recurrence (BCR)-free survival via multivariate Cox proportional regression analysis. Mean postoperative follow-up duration for 307 total patients was 72.1 ± 19.6 months. Kaplan-Meier curve demonstrated that BCR-free survival was significantly worse in patients with higher (≥ 40  ng/mL) SHBG level than others (P < 0.001). Serum T (P = 0.280) and free T (P = 0.606) levels showed no significant association with biochemical outcome. In multivariate analysis encompassing postoperative variables along with PSA, T, and free T, SHBG level (HR 1.825, 1.061-3.138; P = 0.030) was observed to be independently associated with BCR-free survival. Addition of SHBG level to the multivariate model for prediction of BCR-free survival resulted in increased accuracy (83.5% vs. 82.2%; P = 0.164). Our study of patients who were followed up for relative longer periods after RP shows that preoperative serum SHBG level, but not T, is an independent predictor of postoperative BCR-free survival. According to our findings, SHBG measurement may be useful in the selection of candidates for adjuvant treatment following RP.
authors.affiliation: From the Department of Urology, Seoul National University of Hospital, Seoul (JKL); and Department of Urology, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Korea (S-SB, SEL, SKH).
authors.forename: Jung Keun
authors.initials: JK
authors.lastname: Lee
authors.forename: Seok-Soo
authors.initials: SS
authors.lastname: Byun
authors.forename: Sang Eun
authors.initials: SE
authors.lastname: Lee
authors.forename: Sung Kyu
authors.initials: SK
authors.lastname: Hong
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D018572:Disease-Free Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D057234:Preoperative Period; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood* / Q000473:pathology / Q000601:surgery; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D012738:Sex Hormone-Binding Globulin