The Influence of Endogenous Testosterone on Incidental Prostate Cancer after Transurethral Prostate Resection

2021 ◽  
pp. 1-9
Author(s):  
Antonio B. Porcaro ◽  
Salvatore Siracusano ◽  
Nelia Amigoni ◽  
Alessandro Tafuri ◽  
Riccardo Rizzetto ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Clinical Stage ◽  
Prospective Trial ◽  
Positive Association ◽  
Tumor Grade ◽  
Total Testosterone ◽  
Strongly Correlated ◽  
Incidental Prostate Cancer ◽  
Prostate Enlargement ◽  
Tumor Load

<b><i>Objective:</i></b> The aim of the study was to test the hypothesis that endogenous total testosterone (TT) may relate to incidental prostate cancer (iPCA) in patients with lower urinary tract symptoms (LUTS) associated with prostate enlargement undergoing transurethral resection of the prostate (TURP). <b><i>Methods:</i></b> The hypothesis was tested in contemporary cohort of patients who underwent TURP because of LUTS due to prostate enlargement after excluding the suspect of PCA. In period running from January 2017 to November 2019, 389 subjects were evaluated. Endogenous testosterone was measured preoperatively between 8:00 and 10:00 o’clock in the morning. Relationships between TT and iPCA were evaluated by statistical methods. <b><i>Results:</i></b> Overall, iPCA was detected in 18 cases (4.6%) with clinical stage cT1a or International Society of Urologic Pathology (ISUP) &#x3c; 2 in 11 patients (61.1%). Endogenous testosterone was inversely associated with age and BMI in the study population but not in the subgroup with iPCA in wholly endogenous TT strongly correlated to both number of chips involved by cancer (Pearson’s correlation coefficient, <i>r</i> = 0.553; <i>p</i> = 0.017) and ISUP &#x3e; 2 (<i>r</i> = 0.504; <i>p</i> = 0.033). The positive association of endogenous TT with both tumor load and tumor grade was confirmed by the linear regression model with high-regression coefficients for the former (regression coefficient, <i>b</i> = 0.307; 95% confidence interval, 95% CI: 0.062–0.551; and <i>p</i> = 0.017) as for the latter (<i>b</i> = 5.898; 95% CI: 0.546–11.249; and <i>p</i> = 0.033). <b><i>Conclusions:</i></b> Preoperative endogenous TT is associated with features of iPCA. The influence of iPCA on endogenous testosterone needs to be addressed by a large multicenter prospective trial.

scholarly journals Basal total testosterone serum levels predict biopsy and pathological ISUP grade group in a large cohort of Caucasian prostate cancer patients who underwent radical prostatectomy

2020 ◽  
Vol 12 ◽  
pp. 175628722092948
Author(s):  
Alessandro Tafuri ◽  
Marco Sebben ◽  
Riccardo Rizzetto ◽  
Nelia Amigoni ◽  
Aliasger Shakir ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Clinical Stage ◽  
Univariate Analysis ◽  
Specific Antigen ◽  
Positive Association ◽  
Multivariate Model ◽  
Total Testosterone ◽  
Grade Group ◽  
Surgical Specimen ◽  
Grade Groups

Aims: The study aimed to evaluate associations of preoperative total testosterone (TT) with the risk of aggressive prostate cancer (PCA). Materials & methods: From 2014 to 2018, basal TT levels were measured in 726 consecutive PCA patients. Patients were classified according to the International Society of Urologic Pathology (ISUP) system. Aggressive PCA was defined by the detection of ISUP > 2 in the surgical specimen. The logistic regression model evaluated the association of TT and other clinical factors with aggressive PCA. Results: On univariate analysis, there was a significant association of basal TT with the risk of aggressive PCA as well as age, prostate-specific antigen (PSA), percentage of biopsy positive cores (BPC), tumor clinical stage (cT), and biopsy ISUP grade groups. On multivariate analysis, two models were considered. The first (model I) excluded biopsy ISUP grading groups and the second (model II) included biopsy ISUP grade groups. Multivariate model I, revealed TT as well as all other variables, was an independent predictor of the risk of aggressive disease [odds ratio (OR) = 1.585; 95% confidence interval (CI): 1.113–2.256; p = 0.011]. Elevated basal PSA greater than 20 µg/dl was associated with the risk of aggressive PCA. Multivariate model II revealed that basal TT levels maintain a positive association between aggressive PCA, whereas age, BPC, and clinical stage cT3 lost significance. In the final adjusted model, the level of risk of TT did not change from univariate analysis (OR = 1.525; 95% CI: 1.035–2.245; p = 0.011). Conclusion: Elevated preoperative TT levels are associated with the risk of aggressive PCA in the surgical specimen. TT may identify patients who are at risk of aggressive PCA in the low and intermediate European Association of Urology (EAU) risk classes.

Positive Association between Basal Total Testosterone Circulating Levels and Tumor Grade Groups at the Time of Diagnosis of Prostate Cancer

2019 ◽  
Vol 103 (4) ◽  
pp. 400-407 ◽  
Author(s):  
Antonio B. Porcaro ◽  
Alessandro Tafuri ◽  
Marco Sebben ◽  
Marco Pirozzi ◽  
Tania Processali ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Positive Association ◽  
Tumor Grade ◽  
Total Testosterone ◽  
Grade Groups ◽  
Circulating Levels

scholarly journals Endostatin Polymorphism 4349G/A(D104N) is not Associated with Aggressiveness of Disease in Postate Cancer

2005 ◽  
Vol 21 (1) ◽  
pp. 37-41 ◽  
Author(s):  
He Cheng Li ◽  
Qiu Yin Cai ◽  
Eric T. Shinohara ◽  
Hui Cai ◽  
Carolyn Cao ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Clinical Stage ◽  
Tumor Grade ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Exact Test ◽  
Impaired Ability ◽  
Inhibitory Molecule ◽  
Caucasian Patients ◽  
Worse Prognosis

Endostatin is an important inhibitory molecule which mediates the sequential steps involved in angiogenesis. Lower level or impaired function of endostatin is associated with a higher risk of developing malignant solid tumors and with a worse prognosis of the disease. TheendostatinN104 polymorphism might be associated with an impaired ability to inhibit angiogenesis. We analyzed the tissues from 98 Caucasian prostate cancer patients for the presence of D104N polymorphism. The frequencies of homozygous 4349G/G(104D/D), and heterozygous 4349G/A(104D/N) were 83.67%(82/98) and 16.33%(16/98), respectively; no individuals were homozygous 4349A/A(104N/N). With the Fisher’s exact test we found the genotype of D104N was not significantly related to age, tumor grade, PSA and clinical stage (P> 0.05). There was no difference in relapse free survival(RFS) or overall survival(OS) between patients with 104D/N and those with 104D/D (P= 0.8283, 0.3713 respectively). We concluded thatendostatinpolymorphism was not associated with the aggressiveness of prostate cancer in Caucasian patients.

scholarly journals Positive Association between Preoperative Total Testosterone and Lymph Node Invasion in Intermediate Risk Prostate Cancer

2018 ◽  
Vol 12 (4) ◽  
pp. 216-222
Author(s):  
Antonio B. Porcaro ◽  
Alessandro Tafuri ◽  
Marco Sebben ◽  
Paolo Corsi ◽  
Tania Processali ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lymph Node ◽  
Lymph Node Dissection ◽  
Specific Antigen ◽  
Positive Association ◽  
Pelvic Lymph Node Dissection ◽  
Pelvic Lymph Node ◽  
Total Testosterone ◽  
Intermediate Risk ◽  
Node Dissection

Introduction: Prostate cancer (PCa) patients who are classified into the intermediate risk category represent a heterogeneous population needing further preoperative risk assessment. Objectives: To evaluate clinical total testosterone (TT) associations with lymph node invasion (LNI) in intermediate risk PCa. Material and Methods: Between November 2014 and July 2016, intermediate risk PCa was assessed in 154 patients who underwent extended pelvic lymph node dissection if the risk of LNI was higher than 5%. Clinical factors associated with the risk LNI were investigated by the multinomial logistic regression model. Results: The risk of LNI was assessed higher than 5% in 40.9% of cases of whom 15.5% had LNI. In the multivariate model, the risk of LNI was independently increased by prostate specific antigen (OR = 1.185; p = 0.021) and TT (OR = 1.004; p = 0.036). As a result, TT was an independent factor that associated with LNI because it increased the risk of LNI by 4% for each increment unit of TT. Conclusion: Preoperative TT independently increased the risk of LNI in the intermediate risk class of PCa patients elected to radical prostatectomy and extended pelvic lymph node dissection. TT might be a useful preoperative factor for stratifying intermediate risk patients because of the positive association of TT with high grade tumors.

scholarly journals Correlation of serum prostate specific antigen with clinical, radiological and pathological variables in patients with prostate enlargement

2019 ◽  
Vol 6 (12) ◽  
pp. 4408
Author(s):  
Tinku Antony ◽  
Raghav Talwar ◽  
Tina Thomas ◽  
Vikram Trehan ◽  
Shrikant Manwantkar ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Clinical Stage ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Threshold Level ◽  
Gleason Grade ◽  
Chi Square ◽  
Abdominal Ultrasonography ◽  
Prostate Enlargement

Background: Prostate enlargement encompasses a spectrum of disorders ranging from benign to malignant. For diagnostic prostatic biopsies no clear prostate specific antigen (PSA) threshold level exists. The study correlates PSA with various clinical data (age of patient, international prostate severity score (IPSS), digital rectal examination (DRE) finding), radiological data (prostate volume) and pathological data (Gleason grade, prostate cancer stage) to aid decision making on treatment of prostate enlargement.Methods: 101 men aged more than 50 years with fresh LUTS and grade 1 or more prostate enlargement on DRE were enrolled. They were worked up with transabdominal ultrasonography, serum PSA and prostate biopsy (when indicated). A descriptive statistical analysis was done for correlation by applying Pearson’s Chi square test for significance.Results: Mean serum PSA value was found to increase with age and higher IPSS score. Mean serum PSA levels were found to rise with grade of prostatomegaly. No significant correlation was seen between serum PSA values and Gleason grade or clinical stage of prostate cancer.Conclusions: Serum PSA levels has a significant correlation with age. With increasing age there is increase in serum PSA levels. Serum PSA levels has a significant correlation with International prostate symptom severity scoring. Serum PSA levels has a significant correlation with prostate size measured by trans-abdominal ultrasonography. Serum PSA levels does not show significant correlation with Gleason score or clinical stage of prostate cancer.

scholarly journals Estudio Clínico y Epidemiológico de Cáncer de Próstata en el Hospital de Especialidades José Carrasco Arteaga de Cuenca - Ecuador, 2010 - 2015

2018 ◽  
Vol 10 (2) ◽  
pp. 110-115
Author(s):  
María Paz Orellana Jara ◽  
Juana Carolina Cordero Garate ◽  
Galo Rubén Duque Proaño
Keyword(s):  
Prostate Cancer ◽  
Risk Factors ◽  
Correlation Coefficient ◽  
Gleason Score ◽  
Clinical Stage ◽  
Specific Antigen ◽  
Positive Association ◽  
Clinical Staging ◽  
The Media ◽  
Total Psa

BACKGROUND: Prostate cancer is the fifth most common neoplasms worldwide and the second in man. In Cuenca, according to the sixth epidemiology of cancer, it is the second cause of death in males. METHODS: Observational descriptive study the sample was for convenience, made up with 315 patients with positive biopsy. The established variables were: Signs and symptoms, histopathological type, total prostate specific antigen (PSA) measure, risk factors, Gleason score, differentiation grade and clinical staging. The media and median were obtained as the crossing of variables using Pearson and Spearman correlation coefficient. The software used was STATA 12 version. RESULTS: The most common symptoms were urinary frequency (56.2 %) and dysuria (36.8 %). 312 patients presented adenocarcinoma as histopathology type. The total PSA had a median of 4.4 ng/ml and a media of 34 ng/ml. The media of age was 69 years old. 141 patients presented hypertension. About the Gleason Grading system most of people were moderately differentiated (43.6 %). 67 % of cases were diagnosed during stages I and II. The Rho correlation coefficient was 0.44 between clinical stage and Gleason score; it was of 0.36 between PSA and clinical stage. CONCLUSIONS: It was found a moderately positive association between clinical stage and Gleason score. There is no minimal measure of total PSA that could assure us there is no risk of prostate cancer. More prospective studies are needed in order to find the relation between prostate cancer and risk factors.

scholarly journals Simultaneous Measurements of Follicle Stimulating Hormone and Total Testosterone and Associations in Clinically Localized Prostate Cancer

2016 ◽  
Vol 10 (4) ◽  
pp. 174-181
Author(s):  
Antonio B. Porcaro ◽  
Salvatore Siracusano ◽  
Nicolò de Luyk ◽  
Paolo Corsi ◽  
Marco Sebben ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Follicle Stimulating Hormone ◽  
Specific Antigen ◽  
Localized Prostate Cancer ◽  
Total Testosterone ◽  
High Grade ◽  
The Third ◽  
Simultaneous Measurements ◽  
Tumor Load ◽  
Stimulating Hormone

Objectives: To evaluate the potential relations of simultaneous measurements of basal levels of follicle stimulating hormone (FSH) and total testosterone (TT) in clinically localized prostate cancer (PCa). Materials and Methods: The study included 126 patients who had simultaneous measurements of prostate specific antigen (PSA), FSH, and TT before undergoing radical prostatectomy for clinically localized PCa. Correlations and independent associations between clinical and pathological factors were investigated by statistical methods. Results: The tumor volume (TV) was directly correlated to PSA and TT which was inversely related to FSH. Moreover, it was independently associated with both PSA and TT. In a multivariate linear regression model, FSH and TV were simultaneous independent factors associated with TT, and the association was inverse in the former and direct in the latter. In the patient population, the subset with FSH levels above the third quartile was related to lower median levels of TT that were associated with high grade cancer showing a lower TV. In localized PCa, basal levels of TT were associated with tumor parameters and inversely related to FSH levels, and the subset FSH levels above the third quartile were related to lower TT levels that were associated with high grade cancers showing a lower tumor load. Conclusion: Preoperative TT was associated with tumor parameters and inversely related to FSH levels. Patient with increased FSH levels was related to lower levels of TT, which was associated with high grade cancer.

Prostate-specific antigen as a pretherapy prognostic factor in patients treated with radiation therapy for clinically localized prostate cancer.

1993 ◽  
Vol 11 (11) ◽  
pp. 2158-2166 ◽  
Author(s):  
T M Pisansky ◽  
S S Cha ◽  
J D Earle ◽  
E D Durr ◽  
T F Kozelsky ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prognostic Factor ◽  
Prostate Specific Antigen ◽  
Combined Modality Therapy ◽  
Clinical Stage ◽  
Specific Antigen ◽  
Tumor Grade ◽  
Localized Prostate Cancer ◽  
Disease Outcome ◽  
Tumor Relapse

PURPOSE This study was conducted to determine the value of prostate-specific antigen (PSA) as a pretherapy prognostic factor for localized prostate cancer treated with primary irradiation (RT). PATIENTS AND METHODS Between March 1987 and December 1990, 254 patients with pretherapy PSA determinations were treated for clinical stage A2 to C prostate adenocarcinoma. In conjunction with other prognostic factors, pretherapy PSA was evaluated to determine whether it had independent predictive value for disease outcome. RESULTS Pretherapy PSA was highly and directly correlated with clinical stage, tumor grade, and acid phosphatase level. With a median follow-up duration of 24 months, 241 patients (95%) were fully assessable for disease outcome. In these patients, PSA and tumor grade were the sole independent predictive factors for tumor relapse (ie, clinically determined and/or increasing PSA level). The combination of pretherapy PSA and tumor grade information defined groups of patients with distinctly different outcome. For patients in low- (favorable PSA and tumor grade), intermediate- (favorable PSA or tumor grade), and high- (adverse PSA and tumor grade) risk categories, the actuarial rates of survival free of tumor relapse or increasing PSA level were 94%, 77%, and 42% at 3 years, respectively (P < .0001). CONCLUSION Pretherapy PSA is a strongly independent prognostic factor for disease outcome following primary RT. The combination of adverse pretherapy PSA and unfavorable tumor grade identified a cohort of patients with a high risk of early treatment failure in whom combined modality therapy may be appropriately investigated.

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