Low endogenous testosterone level is associated with high-risk prostate-specific antigen level in men with prostate cancer disease

Background: Low serum testosterone levels is hypothesized to predict adverse outcomes in prostate cancer patients. This study was structured to investigate this hypothesis using high-risk serum prostate-specific antigen as a marker of adverse outcome of the disease.Methods: This was a retrospective analysis of serum total testosterone (TT) and total prostate-specific antigen (PSA) records of prostate cancer patients in a tertiary hospital in Nigeria. Records of age, serum TT, and serum PSA test results from 1st January 2008 to 31st December 2017 were acquired from laboratory and medical records and analyzed with SPSS software version 20. Results: The records of 450 men with prostate cancer were recruited for the study. The majority (56.7%) of the study cohorts were between 70 to 79 years of age. Hypogonadism was observed in 34.7% of the study cohort. The hypogonadal patients had higher PSA values compared to the eugonadal patients (p<0.001). Lower testosterone values were observed in patients with high-risk PSA levels (p<0.001). Strong significant negative correlations were observed between total PSA and endogenous testosterone within the overall study cohort (r= -0.792; p< 0.001), the hypogonadal group (r= -0.615; p < 0.001), and among the high-risk PSA group (r= -0.632; p< 0.001). Conclusions: The findings of this study suggest low, rather than high, endogenous testosterone in prostate cancer disease is associated with high-risk PSA levels which implies adverse outcome in prostate cancer patients. However, further studies are warranted to confirm this association.