title: High Testosterone Preoperative Plasma Levels Independently Predict Biopsy Gleason Score Upgrading in Men with Prostate Cancer Undergoing Radical Prostatectomy.
abstract: OBJECTIVE
  The study aims to investigate the potential associations between preoperative plasma levels of total testosterone (TT) and biopsy Gleason score (bGS) upgrading in prostate cancer (PCA) patients undergoing radical prostatectomy (RP).
  
  
  METHODS
  Exclusion criteria were treatment with 5α-reductase inhibitors, LH-releasing hormone analogues or testosterone replacement. Criteria of bGS upgrading were as follows: (i) bGS 6 to pathological Gleason score (pGS) >6, (ii) bGS 7 with pattern 3 + 4 to pGS 7 with pattern 4 + 3 or to pGS >7, (iii) bGS 7 with pattern 4 + 3 to pGS >7. Patients who showed bGS >7 were excluded from the cohort.
  
  
  RESULTS
  The study included 209 patients. Tumor upgrading was assessed in 76 (36.4%) cases of the entire cohort, in 51 out of 130 cases (39.2%) of the bGS 6 group and 25 out of 79 patients (31.6%) in the bGS 7 cluster. Logistic regression models showed that independent clinical covariates predicting the risk of bGS upgrading included TT (OR 1.058; p = 0.027) and prostate-specific antigen (PSA) density (OR 23.3; p = 0.008) as well as TT (OR 1.057; p = 0.029) with PSA (OR 1.061; p = 0.023). The model suggests that 1 unit increase in TT plasma levels increases the odds of bGS upgrading by 5.8 or 5.7%.
  
  
  CONCLUSIONS
  In summary, we have determined that high TT preoperative plasma levels independently predict bGS upgrading in men with PCA undergoing RP. Preoperative plasma levels of TT might be included as a potential marker for assessing the risk bGS upgrading.
authors: Clinica Urologica, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
authors: Antonio Benito
authors: AB
authors: Porcaro
authors: Aldo
authors: A
authors: Petroziello
authors: Matteo
authors: M
authors: Brunelli
authors: Nicolò
authors: N
authors: De Luyk
authors: Giovanni
authors: G
authors: Cacciamani
authors: Paolo
authors: P
authors: Corsi
authors: Marco
authors: M
authors: Sebben
authors: Alessandro
authors: A
authors: Tafuri
authors: Irene
authors: I
authors: Tamanini
authors: Beatrice
authors: B
authors: Caruso
authors: Claudio
authors: C
authors: Ghimenton
authors: Carmelo
authors: C
authors: Monaco
authors: Walter
authors: W
authors: Artibani
mesh_terms: D000368:Aged; D001706:Biopsy; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011467:Prostate / Q000473:pathology*; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000097:blood* / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D013739:Testosterone / Q000097:blood*
chemical_list: D013739:Testosterone