Is there a protective role of testosterone against high-grade prostate cancer? Incidence and severity of prostate cancer in 553 patients who underwent prostate biopsy: a prospective data register

2017 ◽  
Vol 20 (2) ◽  
pp. 125-133 ◽  
Author(s):  
Aksam Yassin ◽  
Mahmoud Salman ◽  
Riadh A. Talib ◽  
Dany-Jan Yassin
2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 128-128
Author(s):  
Aksam Yassin ◽  
Mahmoud Salman

128 Background: Major concern regarding testosterone therapy (TRT) in middle-aged and elderly men is still prostate safety or cancer Methods: 553 prostate biopsies (2008-2013) were performed at our institute. 22 patients refused biopsy. We investigated incidence and severity of PCa in three groups: hypogonadal (T ≤ 350 ng/dl) men receiving TRT, hypogonadal untreated, and eugonadal men. All groups underwent similar screening intensity of at least once per year. Biopsies were performed when indicated according to EAU guidelines. Results: In 42 hypogonadal men receiving TRT, 7 (16.7%) had a positive biopsy. Of these, 5 had a Gleason score ≤ 6 (71.4%) and 2 subjects a Gleason score > 6 (28.6%). Predominant Gleason score was 3 in all 7 men (100%). Tumor grade was II in 6 (85.7%) and II-III in 1 (14.3%) men. 162 untreated hypogonadal men, 84 (51.9%) had a positive biopsy. Of these, 34 had a Gleason score ≤ 6 (40.5%) and 50 a Gleason score > 6 (59.5%). Predominant Gleason score was 3 in 65 (77.4%), 4 in 17 (20.2%) and 5 in 2 (2.4%) men. Tumor grade was II in 35 (41.7%), II-III in 10 (11.9%), III in 34 (40.5%) and IV in 5 (6.0%) men. In 349 eugonadal men, 132 (37.8%) had a positive biopsy. Of these, 56 had a Gleason score ≤ 6 (42.4%) and 76 a Gleason score > 6 (57.6%). Predominant Gleason score was 3 in 109 (82.6%), 4 in 22 (16.7%) and 5 in 1 (0.1%) men. Tumor grade was II in 59 (44.7%), II-III in 6 (4.5%), III in 63 (47.7%) and IV in 4 (3.0%) men. Conclusions: The incidence of positive prostate biopsies was lowest in hypogonadal men receiving TRT. The severity of PCa – in terms of Staging and Grading - was significantly lower in hypogonadal patients receiving TRT. TRT may protect against high-grade PCa. Protective role of TRT against PCa must be discussed and considered in larger studies.


2013 ◽  
Vol 3 (3-S2) ◽  
pp. 115
Author(s):  
Laurence Klotz ◽  
Darrel Drachenberg ◽  
Yves Fradet ◽  
Fred Saad ◽  
John Trachtenberg ◽  
...  

The recent Prostate Chemoprevention Trial (PCPT), which assessed the efficacyof finasteride in reducing prostate cancer incidence, showed promising results.However, patients who developed cancer had higher Gleason scores than thoseon placebo. Moreover, recent evidence has shown that the biopsy Gleason scoresin patients on finasteride were actually more accurate compared with patientson placebo when matched with the final, radical prostatectomy (RP) scores. Thisaccuracy was due to a reduction in prostate volume induced by the drug, andbetter performance of prostate-specific antigen correlation for identifying menwith high-grade cancer. Re-evaluation of the results based on the pathology ofthe RP specimens and longer follow-up showed a 30% reduction in cancerincidence with finasteride and no significant differences in Gleason scorescompared with placebo


2016 ◽  
Vol 34 (32) ◽  
pp. 3880-3885 ◽  
Author(s):  
Eric J. Jacobs ◽  
Rebecca L. Anderson ◽  
Victoria L. Stevens ◽  
Christina C. Newton ◽  
Ted Gansler ◽  
...  

Purpose In a recent large prospective study, vasectomy was associated with modestly higher risk of prostate cancer, especially high-grade and lethal prostate cancer. However, evidence from prospective studies remains limited. Therefore, we assessed the associations of vasectomy with prostate cancer incidence and mortality in a large cohort in the United States. Patients and Methods We examined the association between vasectomy and prostate cancer mortality among 363,726 men in the Cancer Prevention Study II (CPS-II) cohort, of whom 7,451 died as a result of prostate cancer during follow-up from 1982 to 2012. We also examined the association between vasectomy and prostate cancer incidence among 66,542 men in the CPS-II Nutrition Cohort, a subgroup of the CPS-II cohort, of whom 9,133 were diagnosed with prostate cancer during follow-up from 1992 to 2011. Cox proportional hazards regression modeling was used to estimate multivariable-adjusted hazard ratios (HRs) and 95% CIs. Results In the CPS-II cohort, vasectomy was not associated with prostate cancer mortality (HR, 1.01; 95% CI, 0.93 to 1.10). In the CPS-II Nutrition Cohort, vasectomy was not associated with either overall prostate cancer incidence (HR, 1.02; 95% CI, 0.96 to 1.08) or high-grade prostate cancer incidence (HR, 0.91; 95% CI, 0.78 to 1.07 for cancers with Gleason score ≥ 8). Conclusion Results from these large prospective cohorts do not support associations of vasectomy with either prostate cancer incidence or prostate cancer mortality.


2005 ◽  
Vol 173 (4S) ◽  
pp. 129-129
Author(s):  
John F. Donohue ◽  
Fernando J. Bianco ◽  
Kentaro Kuroiwa ◽  
Andrew J. Vickers ◽  
Thomas M. Wheeler ◽  
...  

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