Alternative inflammatory cytokines pathways in prostate cancer: In search of new therapeutic options.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e17504-e17504
Author(s):  
Marlena Janiczek ◽  
Łukasz Szylberg ◽  
Paulina Antosik ◽  
Andrzej Marszalek
Keyword(s):  
Prostate Cancer ◽  
Immune Response ◽  
Statistical Analysis ◽  
Gleason Score ◽  
Inflammatory Process ◽  
Inflammatory Factors ◽  
Control Group ◽  
Inflammatory Pathway ◽  
Gleason Grading ◽  
Starting Point

e17504 Background: The inflammatory reaction pathways have impact on tumor cells development or anti-tumor responses. Both by the activity of the innate and acquired immune response signalling pathways. A proper acquired immune response is considered as anti-tumor. While inadequate innate or acquired stimulation of the immune system can cause chronic inflammation that can lead to oncogenesis. Numerous reports have revealed a relationship between chronic prostatitis and prostate cancer (PCa). The aim of the study is to retrospectively assess the histological material of PCa with the Gleason grading score. The histological material evaluated the level of inflammatory factors of pathways initiated by IL-17A and IL-17F. The evaluation of the expression of pro-inflammatory factors such as IL-17A, IL-17F, IL-17RA, IL-17RC, AKT1, EBPbeta, TRAF 6 and NF-kB made it possible to assess the influence of the inflammatory process on the progression of PCa. Methods: Studies were carried out on archival tissue material in the form of paraffin blocks of 40 men with PCa after radical prostatectomy. The control group of 10 men with benign prostatic hyperplasia (BPH). The material was obtained by the transurethral resection of the prostate (TURP). The immunohistochemistry was performed on the material prepared in this way using specific primary antibodies against IL-17A, IL-17F, IL-17RA, IL-17RC, ACT1, TRAF-6, C/EBPbeta and NF-kB. The expression of the antibody to be examined using the light microscopy and the Remmele Stegner score (IRS) in cancer staining were then evaluated. Statistical analysis was performed using the non-parametric Kruskal-Wallis test. Results: In statistical analysis, it was shown that the inflammatory pathway IL17A/IL-17RC/TRAF6/NF-kB occurs in both BPH and PCa. IL-17 RA did not show expression in any group of patients and in the control group. In addition, along with the increase in the grading of Gleason score, a decrease in the expression of the tested inflammatory parameters was demonstrated. Conclusions: The inflammatory process has an impact on the cancer of prostate cancer. There is a correlation between the grades according to Gleason score and the level of expression of inflammation parameters. Activation of the inflammatory pathway through IL17A/IL-17RC/TRAF6/NF-kB cascade could correlate PCa development on the base of BPH. Evaluation of the inflammatory pathway in PCa, the initiated IL-17, may become a starting point for further research on an attempt to use, for example, immunotherapy in PCa.

scholarly journals Expression Levels of IL-17A, IL-17F, IL-17RA, and IL-17RC in Prostate Cancer with Taking into Account the Histological Grade according to Gleason Scale in Comparison to Benign Prostatic Hyperplasia: In Search of New Therapeutic Options

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Marlena Janiczek ◽  
Łukasz Szylberg ◽  
Paulina Antosik ◽  
Anna Kasperska ◽  
Andrzej Marszałek
Keyword(s):  
Prostate Cancer ◽  
Benign Prostatic Hyperplasia ◽  
Gleason Score ◽  
Inflammatory Process ◽  
Histological Grade ◽  
Prostatic Hyperplasia ◽  
Control Group ◽  
Inflammatory Parameters ◽  
Starting Point ◽  
The Impact

Prostate cancer (PCa) is the second most commonly diagnosed malignant tumor and the fifth leading cause of cancer death in men in the world. The most common types of tumors are adenocarcinomas. Prostate cancer is a slow-growing cancer. The incidence increases with age. Evaluation of proinflammatory factors such as IL-17A, IL-17F, IL-17RA, and IL-17RC expression makes it possible to assess the impact of inflammatory process on progression of PCa. The aim of the study was to retrospectively assess the histological material of PCa divided into few groups using the Gleason score. Studies were carried out on archival tissue material in the form of paraffin blocks of 40 men with PCa after radical prostatectomy. The control group was composed of 10 men with benign prostatic hyperplasia (BPH). The material was obtained by the transurethral resection of the prostate (TURP). Immunohistochemistry was performed on prepared material using specific primary antibodies against IL-17A, IL-17F, IL-17RA, and IL-17RC. Expression of the antibody to be examined using light microscopy and the Remmele-Stegner score (IRS) in cancer staining was then evaluated. Expression of IL-17 RA was not shown in a group of patients with PCa and in the control group. In the group of patients with Gleason score 8 and 9 PCa, the expression of IL-17A was higher compared to that of IL-17F. In addition, in PCa with an increased grade of Gleason scale, a decrease in the expression of the study inflammatory parameters was found. The inflammatory process has an impact on PCa. A study on IL-17 may become a starting point for further research on an attempt to use, for example, immunotherapy in PCa.

scholarly journals Gleason Score and Lethal Prostate Cancer: Does 3 + 4 = 4 + 3?

2009 ◽  
Vol 27 (21) ◽  
pp. 3459-3464 ◽  
Author(s):  
Jennifer R. Stark ◽  
Sven Perner ◽  
Meir J. Stampfer ◽  
Jennifer A. Sinnott ◽  
Stephen Finn ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Gleason Score ◽  
Predictive Ability ◽  
Fold Increase ◽  
Health Study ◽  
Prognostic Information ◽  
Gleason Grading ◽  
Gleason Pattern ◽  
C Statistic ◽  
Bony Metastases

Purpose Gleason grading is an important predictor of prostate cancer (PCa) outcomes. Studies using surrogate PCa end points suggest outcomes for Gleason score (GS) 7 cancers vary according to the predominance of pattern 4. These studies have influenced clinical practice, but it is unclear if rates of PCa mortality differ for 3 + 4 and 4 + 3 tumors. Using PCa mortality as the primary end point, we compared outcomes in Gleason 3 + 4 and 4 + 3 cancers, and the predictive ability of GS from a standardized review versus original scoring. Patients and Methods Three study pathologists conducted a blinded standardized review of 693 prostatectomy and 119 biopsy specimens to assign primary and secondary Gleason patterns. Tumor specimens were from PCa patients diagnosed between 1984 and 2004 from the Physicians' Health Study and Health Professionals Follow-Up Study. Lethal PCa (n = 53) was defined as development of bony metastases or PCa death. Hazard ratios (HR) were estimated according to original GS and standardized GS. We compared the discrimination of standardized and original grading with C-statistics from models of 10-year survival. Results For prostatectomy specimens, 4 + 3 cancers were associated with a three-fold increase in lethal PCa compared with 3 + 4 cancers (95% CI, 1.1 to 8.6). The discrimination of models of standardized scores from prostatectomy (C-statistic, 0.86) and biopsy (C-statistic, 0.85) were improved compared to models of original scores (prostatectomy C-statistic, 0.82; biopsy C-statistic, 0.72). Conclusion Ignoring the predominance of Gleason pattern 4 in GS 7 cancers may conceal important prognostic information. A standardized review of GS can improve prediction of PCa survival.

scholarly journals Salidroside regulates inflammatory pathway of alveolar macrophages by influencing the secretion of miRNA-146a exosomes by lung epithelial cells

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Lanzhi Zheng ◽  
Jianming Su ◽  
Zhuoyi Zhang ◽  
Lu Jiang ◽  
Jinling Wei ◽  
...  
Keyword(s):  
Intratracheal Instillation ◽  
Particle Size Analysis ◽  
Lung Epithelial Cells ◽  
Inflammatory Factors ◽  
Size Analysis ◽  
Control Group ◽  
Protein Marker ◽  
Inflammatory Pathway ◽  
Tail Vein ◽  
Nr8383 Cells

AbstractThe purpose of this study was to explore the investigative mechanism of salidroside (SAL) on LPS-induced acute lung injury (ALI)/acute respiratory distress syndrome (ARDS). The exosomes from RLE-6TN are extracted and identified by transmission electron microscopy, particle size analysis and protein marker detection, and co-cultured with NR8383 cells. The ALI/ARDS model of SD rats was established by LPS (10 mg/kg) intratracheal instillation. Following a four-hour intratracheal instillation of LPS, 50 μl of RLE-6TN exosomes were injected through the tail vein. After that, SAL and miR-146a antagomir were injected into the tail vein for 72 h, respectively. As the changes of HE stain, body weight and ALI score are observed. The expression of miR-146a, TLR4, NF-kB, IRAK1, TRAF6 and their related proteins were detected by RT-PCR and Western blot, respectively. TNF-α, IL-6, IL-8 and IL-1 β inflammatory factors were detected by ELISA. The expression of miR-146a, NF-kB, IRAK, TRAF6 and related inflammatory factors in LPS-induced NR8383 was significantly higher than that in the control group, while SAL has greatly reduced the expression of TLR4 mediated NF-kB inflammatory pathway and related inflammatory factors. SAL can significantly improve the LPS-induced lung morphological abnormalities, slowed down the rate of weight loss in rats, and reducing the ALI score. The expression trend of NF-kB, IRAK, TRAF6 and related inflammatory factors in rats’ lung tissues was consistent with that in NR8383 cells. SAL has a protective effect on ALI/ARDS caused by sepsis, which is likely to be developed to a potential treatment for the disease. To sum up, this study provides a new theoretical basis for the treatment of ALI/ARDS with SAL.

Prognostic Value of Endocan in Prostate Cancer: Clinicopathologic Association between Serum Endocan Levels and Biochemical Recurrence after Radical Prostatectomy

2016 ◽  
Vol 103 (2) ◽  
pp. 204-208 ◽  
Author(s):  
Burak Arslan ◽  
Özkan Onuk ◽  
İsmet Hazar ◽  
Muammer Aydın ◽  
Nusret Can Çilesiz ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Gleason Score ◽  
Biochemical Recurrence ◽  
Specific Antigen ◽  
Elevated Serum ◽  
Progression Free Survival ◽  
Control Group ◽  
Free Survival ◽  
Biochemical Progression

Purpose To assess the diagnostic capability of serum endocan level in association with clinicopathologic features and its impact on biochemical progression-free survival in patients with prostate cancer (PCa). Methods A total of 86 patients with localized prostate cancer were treated with open radical prostatectomy (RP). The control group included 80 patients who were referred to the urology outpatient clinic with normal rectal examination and prostate-specific antigen (PSA) levels. The patients’ characteristics, baseline PSA value, and serum endocan levels were recorded. The patients were followed up with the measurement of PSA concentration every 3 months during the first year, thereafter every 6 months until 5 years, then yearly after surgery. The primary endpoint of follow-up was the time of biochemical recurrence. Results The median serum endocan levels were 3.14 ng/mL in the RP group and 2.98 ng/mL in the control group (p = 0.122). A total of 86 patients who underwent RP for PCa were divided into 2 groups based on a cutoff serum endocan level of 1.8 ng/mL. The distribution of Gleason score and biochemical failure rate were significantly higher in patients with serum endocan ≥1.8 ng/mL (p = 0.031 and p = 0.047). The biochemical recurrence-free time for endocan ≥1.8 ng/mL and <1.8 ng/mL were 38 and 56 months, respectively (p = 0.041). Spearman correlation analysis showed a linear relationship between endocan expression and Gleason score (p = 0.025, p = 0.511). Multivariate analysis revealed that elevated serum endocan level (≥1.8 ng/mL) was a significant predictor of biochemical progression-free survival (hazard ratio 2.44; 95% confidence interval 1.78-3.23; p = 0.001). Conclusions The current study indicates that endocan has a close relationship with tumor recurrence in PCa.

scholarly journals Automated Gleason grading of prostate cancer tissue microarrays via deep learning

2018 ◽  
Author(s):  
Eirini Arvaniti ◽  
Kim S. Fricker ◽  
Michael Moret ◽  
Niels J. Rupp ◽  
Thomas Hermanns ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Deep Learning ◽  
Gleason Score ◽  
Survival Data ◽  
Kappa Statistic ◽  
Tissue Microarrays ◽  
Cancer Tissue ◽  
Gleason Grading ◽  
Automated Annotation ◽  
Prostate Cancer Tissue

AbstractThe Gleason grading system remains the most powerful prognostic predictor for patients with prostate cancer since the 1960’s. Its application requires highly-trained pathologists, is tedious and yet suffers from limited inter-pathologist reproducibility, especially for the intermediate Gleason score 7. Automated annotation procedures constitute a viable solution to remedy these limitations.In this study, we present a deep learning approach for automated Gleason grading of prostate cancer tissue microarrays with Hematoxylin and Eosin (H&E) staining. Our system was trained using detailed Gleason annotations on a discovery cohort of 641 patients and was then evaluated on an independent test cohort of 245 patients annotated by two pathologists. On the test cohort, the inter-annotator agreements between the model and each pathologist, quantified via Cohen’s quadratic kappa statistic, were 0.75 and 0.71 respectively, comparable with the inter-pathologist agreement (kappa=0.71). Furthermore, the model’s Gleason score assignments achieved pathology expert-level stratification of patients into prognostically distinct groups, on the basis of disease-specific survival data available for the test cohort.Overall, our study shows promising results regarding the applicability of deep learning-based solutions towards more objective and reproducible prostate cancer grading, especially for cases with heterogeneous Gleason patterns.

Comparison of Classic and International Society of Urological Pathology 2005 Modified Gleason Grading Using Needle Biopsies From the Reduction by Dutasteride of Prostate Cancer Events (REDUCE) Trial

2013 ◽  
Vol 137 (12) ◽  
pp. 1740-1746 ◽  
Author(s):  
M. Scott Lucia ◽  
David G. Bostwick ◽  
Matthew C. Somerville ◽  
Ivy L. Fowler ◽  
Roger S. Rittmaster
Keyword(s):  
Prostate Cancer ◽  
Gleason Score ◽  
International Society ◽  
Scoring System ◽  
Interobserver Agreement ◽  
Scoring Systems ◽  
High Grade ◽  
Gleason Grading ◽  
Modified Gleason Grading ◽  
Score Distributions

Context.—Use of the International Society of Urological Pathology (ISUP) 2005 modified Gleason score may result in higher scores compared with the classic Gleason scoring system. Objective.—To compare scores derived using the 2 scoring systems. Design.—On-study and for-cause biopsies were centrally reviewed and assigned a classic Gleason score in the Reduction by Dutasteride of prostate Cancer Events trial. Positive biopsies were reviewed by an independent pathologist in a secondary review using the ISUP 2005 modified Gleason score. The independent pathologist also recorded a classic Gleason score. Results.—In total, 1482/1507 (98%) positive biopsy results were independently reviewed. Scores assigned by the 2 pathologists (classic versus modified) agreed in 83% (1230 of 1481) of cases; 99% (1471 of 1481) of cancers were within ±1 of their previous score. Of discordant cases, similar numbers of biopsies were upgraded and downgraded in the secondary review, with minor differences in the score distributions. Interobserver agreement was good, with κ values ranging from 0.62 (95% confidence interval [CI], 0.56–0.67) to 0.70 (95% CI, 0.65–0.76). The overall number of high-grade tumors (Gleason score 8–10; n = 48) remained constant between reviews, with 3 fewer cases in the placebo group (n = 16) and 3 more in the dutasteride group (n = 32) in the secondary review. When comparing the independent pathologist's modified scores versus the classic, 17 of 1481 cancers (1.1%) were upgraded (including 9 of 17 upgrades [53%] to high-grade tumors). Conclusions.—This analysis showed similar score distributions between the classic and modified Gleason scoring systems. The differences seen between the 2 pathologists' scores likely reflect differences in interpretation rather than the scoring system chosen.

scholarly journals Novel Metabolic Signatures of Prostate Cancer Revealed by 1H-NMR Metabolomics of Urine

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 149
Author(s):  
Bo Yang ◽  
Chuan Zhang ◽  
Sheng Cheng ◽  
Gonghui Li ◽  
Jan Griebel ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
1H Nmr ◽  
Gleason Score ◽  
Wilcoxon Test ◽  
Control Group ◽  
Pathway Enrichment Analysis ◽  
Potential Candidate ◽  
Differential Analysis ◽  
Operating Characteristics ◽  
Novel Biomarkers

Prostate cancer (PC) is one of the most common male cancers worldwide. Until now, there is no consensus about using urinary metabolomic profiling as novel biomarkers to identify PC. In this study, urine samples from 50 PC patients and 50 non-cancerous individuals (control group) were collected. Based on 1H nuclear magnetic resonance (1H-NMR) analysis, 20 metabolites were identified. Subsequently, principal component analysis (PCA), partial least squares-differential analysis (PLS-DA) and ortho-PLS-DA (OPLS-DA) were applied to find metabolites to distinguish PC from the control group. Furthermore, Wilcoxon test was used to find significant differences between the two groups in metabolite urine levels. Guanidinoacetate, phenylacetylglycine, and glycine were significantly increased in PC, while L-lactate and L-alanine were significantly decreased. The receiver operating characteristics (ROC) analysis revealed that the combination of guanidinoacetate, phenylacetylglycine, and glycine was able to accurately differentiate 77% of the PC patients with sensitivity = 80% and a specificity = 64%. In addition, those three metabolites showed significant differences in patients stratified for Gleason score 6 and Gleason score ≥7, indicating potential use to detect significant prostate cancer. Pathway enrichment analysis using the KEGG (Kyoto Encyclopedia of Genes and Genomes) and the SMPDB (The Small Molecule Pathway Database) revealed potential involvement of KEGG “Glycine, Serine, and Threonine metabolism” in PC. The present study highlights that guanidinoacetate, phenylacetylglycine, and glycine are potential candidate biomarkers of PC. To the best knowledge of the authors, this is the first study identifying guanidinoacetate, and phenylacetylglycine as potential novel biomarkers in PC.

scholarly journals Predictive Clinicopathologic Features and Prognostic assessment of pT0 prostate cancer: a case control study

2020 ◽  
Author(s):  
Jiangnan Xu ◽  
Chao Wang ◽  
Jun Ouyang ◽  
Jianglei Zhang ◽  
Zekun Xu
Keyword(s):  
Prostate Cancer ◽  
Gleason Score ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Clinicopathological Features ◽  
Control Group ◽  
Prognostic Assessment ◽  
Positive Biopsy ◽  
Biopsy Core ◽  
Biopsy Gleason Score

Abstract Background: pT0 prostate cancer is relatively rare. We wanted to share and explore the predictive clinicopathological features and prognosis of biopsy-proven pT0 prostate cancer in Chinese population.Methods: We retrospectively analyzed the clinicopathological and prognostic data of 8 patients with pT0 prostate cancer who received radical prostatectomy (RP) at our institution between 2006 and 2019. pT0 group was compared with a control group of 96 patients who underwent RP during the same period. Exclusion criteria included patients undergoing neoadjuvant hormone therapy or transurethral resection of the prostate (TURP) before the operation．Results: There were significant differences in the exposure rates of six clinicopathological features between two groups. Apart from finasteride use, the other five items were particularly frequent in the pT0 group: prostate-specific antigen (PSA) <10 ng/ml (7/8), one positive biopsy core only (7/8), biopsy Gleason score <7 (8/8), and prostate volume>40ml (7/8), length of biopsy positive for cancer≤2mm. When these five parameters were combined as predictive model, the sensitivity was 75%, the specificity was 99%. The 8 patients were followed up for an average of 67 months without biochemical recurrence or progression.Conclusions: Preoperative PSA, number of positive biopsy core, Gleason score, prostate volume, and the length of cancer can help predict pT0 stage of prostate cancer. Patients with pT0 stage had a relatively favorable prognosis.

scholarly journals The Value of P504s, 34βE12, Ki-67 and PSA in Diagnosis and Prognosis of Prostate Cancer

2020 ◽  
Vol 4 (1) ◽  
pp. 88-93
Author(s):  
Jin-Qi Song ◽  
Ya-Nan Zhou ◽  
Gang-Liang Tu ◽  
Hui Xu
Keyword(s):  
Prostate Cancer ◽  
Gleason Score ◽  
Poor Prognosis ◽  
Specific Antigen ◽  
Control Group ◽  
Ki 67 ◽  
Prostate Hyperplasia ◽  
Diagnosis And Prognosis ◽  
Diagnosis Rate ◽  
The Difference

Background: In recent years, the incidence of prostate cancer (PCa) is increasing. Advanced PCa has a poor prognosis and high cost, which seriously affects the quality of life of patients. Therefore, how to improve the diagnosis rate and prognosis of early PCa is the focus of clinical research. This paper aims to investigate the value of  P504s, 34βE12, Ki-67 and prostate-specific antigen (PSA) in the diagnosis and prognosis of PCa. Objective: To investigate the expression of P504s, 34βE12, Ki67 and PSA in prostate tissues and their clinical significance. Methods: Twenty four cases in the study group were selected from PCa confirmed by pathology in the urology department of Chengde Affiliated Hospital from October 2018 to August 2020, and 33 cases of Benign Prostate Hyperplasia (BPH) confirmed by pathology in the same period were selected as the control group. The expression of P504s, 34βE12 and Ki-67 in prostate tissues were determined by immunohistochemistry. Results: The positive expression rates of P504s, 34βE12 and TPSA or F/TPSA in PCa patients were 95.8%, 12.5% and 87.5%, respectively. The positive rates in BPH patients were 9.1%, 93.9% and 27.3%. The difference between the two groups was statistically significant (p<0.05). PCa bone or lymph node metastasis was positively correlated with Ki-67 (r=0.423, p<0.05) and Gleason score (r=0.446, p<0.05), indicating a stronger correlation with Gleasonscore. Conclusion: The combined detection of P504s, 34βE12 and PSA is helpful for the diagnosis and differential diagnosis of PCa. High Gleason score and ki-67 expression may indicate high risk of PCa metastasis and poor prognosis.

Incidence and severity of prostate cancer in 360 hypogonadal men treated with testosterone undecanoate injections (TU) for up to 8 years and 296 untreated hypogonadal controls.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 50-50
Author(s):  
Ahmad Haider ◽  
Karim Sultan Haider
Keyword(s):  
Prostate Cancer ◽  
Lymph Nodes ◽  
Gleason Score ◽  
Term Treatment ◽  
Control Group ◽  
Registry Study ◽  
Testosterone Undecanoate ◽  
Ctrl Group ◽  
Long Term Treatment

50 Background: Testosterone therapy (TTh) in middle-aged and elderly men is still associated with concerns regarding prostate cancer (PCa). In this registry study, we investigated the incidence of PCa in hypogonadal patients on long-term treatment with TU in comparison to an untreated hypogonadal control group (CTRL). Methods: In a cumulative registry study, 360 men (mean age: 57.37±7.29 years, range: 33-70) with testosterone (T) ≤12.1 nmol/L received TU 1000 mg every 12 weeks following an initial interval of 6 weeks for up to 8 years. 296 hypogonadal men (mean age: 64.79±4.28 years, range: 57-74) decided against TTh, mainly due to financial reasons. Prostate volume (PV) and PSA were measured and digital rectal examination (DRE)/ transrectal ultrasound (TRUS) performed before treatment initiation and then regularly every 3-6 months. Biopsies were performed when indicated according to EAU guidelines. Results: From baseline to 8 years, PV increased from 29.24±10.38 to 31.13±11.45 ml in the T group and remained stable from 34.45±5.89 to 33.51±12 in CTRL. PSA increased slightly from 1.74 ± 0.93 to 1.83±0.93 ng/ml in the T group and remained stable from 2.25±1.34 to 2.19±1.17 in CTRL. In T-treated patients, 7 men (1.9%) were diagnosed with PCa. In the control group, 12 (4.1%) were diagnosed with PCa. The incidence per 10,000 years was 30.05 in the T group and 63.54 in CTRL. The mean age of PCa patients was 64 years in the T group and 65 years in CTRL. All patients underwent radical prostatectomy. The predominant Gleason score was 3 in all patients in the T group, lymph nodes and surgical margins were negative. In CTRL, three men had a predominant Gleason score of 3, 8 had 4, and 1 had 5. 7 patients had positive lymph nodes and no patient had a positive surgical margin. Conclusions: Long-term treatment with TU in hypogonadal men undergoing regular monitoring according to EAU guidelines does not increase the incidence of PCa in comparison to an untreated hypogonadal CTRL group. PCa was more severe in the CTRL group.

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