Association of preoperative testosterone levels with biochemical failure in men undergoing radical prostatectomy

Bryan Bruner, Ajay Nehra, Laureano Rangel, Chris Bailey, Eric Bergstralh, Michael Blute, Robert Jeffrey Karnes

Research output: Contribution to journalArticle

Abstract

Background: Low testosterone levels in men treated with radical prostatectomy (RP) for prostate cancer have been associated with worse pathological stage and outcomes. Long-term data correlating preoperative testosterone levels and RP outcomes are presented. Methods: A total of 177 patients were identified who had preoperative testosterone levels and were treated with RP with long-term follow-up. Associations of testosterone levels with tumor stage, Gleason score, and time to biochemical failure (BCF) were assessed using Pearson's chi-square test, Mantel-Haenszel test, Spearman rank correlation, and life-table methods (Kaplan-Meier curves, log-rank test, Cox proportional hazards model) as appropriate. Testosterone was analyzed both as a continuous factor and as low ( < 300 ng/dl) versus normal testosterone levels. Results: The median testosterone level was 423 ng/dl, median age was 65 years, and median follow-up was approximately 15 years. A significant association between testosterone values below 300 ng/dl and positive surgical margin ( p = 0.0389) as well as seminal vesicle invasion ( p = 0.0182) was found. While patients with a testosterone level < 300 ng/dl also showed a higher percentage of BCF over time (45% vs. 29% at 15 years), the difference was not statistically significant ( p = 0.076, log-rank test). When adjusted for known predictors of BCF (Gleason score, pre-RP prostate-specific antigen, seminal vesicle involvement, and positive surgical margin), the effect of testosterone as a continuous predictor was not statistically significant ( p = 0.57). Conclusion: The longest follow-up to date (15 years) correlating preoperative testosterone levels and RP outcomes is presented. With this study, low testosterone levels were significantly associated with a positive surgical margin and seminal vesicle invasion, and slightly higher ( p = 076) BCF rates.

Original languageEnglish (US)
Pages (from-to)129-133
Number of pages5
JournalJournal of Men's Health
Volume10
Issue number4
DOIs
StatePublished - 2013

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Prostatectomy
Testosterone
Seminal Vesicles
Neoplasm Grading
Life Tables
Chi-Square Distribution
Prostate-Specific Antigen
Proportional Hazards Models
Prostatic Neoplasms

Keywords

  • hypogonadism
  • prostate cancer
  • sexual medicine
  • urology

ASJC Scopus subject areas

  • Medicine(all)
  • Urology

Cite this

Association of preoperative testosterone levels with biochemical failure in men undergoing radical prostatectomy. / Bruner, Bryan; Nehra, Ajay; Rangel, Laureano; Bailey, Chris; Bergstralh, Eric; Blute, Michael; Karnes, Robert Jeffrey.

In: Journal of Men's Health, Vol. 10, No. 4, 2013, p. 129-133.

Research output: Contribution to journalArticle

Bruner, Bryan ; Nehra, Ajay ; Rangel, Laureano ; Bailey, Chris ; Bergstralh, Eric ; Blute, Michael ; Karnes, Robert Jeffrey. / Association of preoperative testosterone levels with biochemical failure in men undergoing radical prostatectomy. In: Journal of Men's Health. 2013 ; Vol. 10, No. 4. pp. 129-133.
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abstract = "Background: Low testosterone levels in men treated with radical prostatectomy (RP) for prostate cancer have been associated with worse pathological stage and outcomes. Long-term data correlating preoperative testosterone levels and RP outcomes are presented. Methods: A total of 177 patients were identified who had preoperative testosterone levels and were treated with RP with long-term follow-up. Associations of testosterone levels with tumor stage, Gleason score, and time to biochemical failure (BCF) were assessed using Pearson's chi-square test, Mantel-Haenszel test, Spearman rank correlation, and life-table methods (Kaplan-Meier curves, log-rank test, Cox proportional hazards model) as appropriate. Testosterone was analyzed both as a continuous factor and as low ( < 300 ng/dl) versus normal testosterone levels. Results: The median testosterone level was 423 ng/dl, median age was 65 years, and median follow-up was approximately 15 years. A significant association between testosterone values below 300 ng/dl and positive surgical margin ( p = 0.0389) as well as seminal vesicle invasion ( p = 0.0182) was found. While patients with a testosterone level < 300 ng/dl also showed a higher percentage of BCF over time (45{\%} vs. 29{\%} at 15 years), the difference was not statistically significant ( p = 0.076, log-rank test). When adjusted for known predictors of BCF (Gleason score, pre-RP prostate-specific antigen, seminal vesicle involvement, and positive surgical margin), the effect of testosterone as a continuous predictor was not statistically significant ( p = 0.57). Conclusion: The longest follow-up to date (15 years) correlating preoperative testosterone levels and RP outcomes is presented. With this study, low testosterone levels were significantly associated with a positive surgical margin and seminal vesicle invasion, and slightly higher ( p = 076) BCF rates.",
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AU - Karnes, Robert Jeffrey

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N2 - Background: Low testosterone levels in men treated with radical prostatectomy (RP) for prostate cancer have been associated with worse pathological stage and outcomes. Long-term data correlating preoperative testosterone levels and RP outcomes are presented. Methods: A total of 177 patients were identified who had preoperative testosterone levels and were treated with RP with long-term follow-up. Associations of testosterone levels with tumor stage, Gleason score, and time to biochemical failure (BCF) were assessed using Pearson's chi-square test, Mantel-Haenszel test, Spearman rank correlation, and life-table methods (Kaplan-Meier curves, log-rank test, Cox proportional hazards model) as appropriate. Testosterone was analyzed both as a continuous factor and as low ( < 300 ng/dl) versus normal testosterone levels. Results: The median testosterone level was 423 ng/dl, median age was 65 years, and median follow-up was approximately 15 years. A significant association between testosterone values below 300 ng/dl and positive surgical margin ( p = 0.0389) as well as seminal vesicle invasion ( p = 0.0182) was found. While patients with a testosterone level < 300 ng/dl also showed a higher percentage of BCF over time (45% vs. 29% at 15 years), the difference was not statistically significant ( p = 0.076, log-rank test). When adjusted for known predictors of BCF (Gleason score, pre-RP prostate-specific antigen, seminal vesicle involvement, and positive surgical margin), the effect of testosterone as a continuous predictor was not statistically significant ( p = 0.57). Conclusion: The longest follow-up to date (15 years) correlating preoperative testosterone levels and RP outcomes is presented. With this study, low testosterone levels were significantly associated with a positive surgical margin and seminal vesicle invasion, and slightly higher ( p = 076) BCF rates.

AB - Background: Low testosterone levels in men treated with radical prostatectomy (RP) for prostate cancer have been associated with worse pathological stage and outcomes. Long-term data correlating preoperative testosterone levels and RP outcomes are presented. Methods: A total of 177 patients were identified who had preoperative testosterone levels and were treated with RP with long-term follow-up. Associations of testosterone levels with tumor stage, Gleason score, and time to biochemical failure (BCF) were assessed using Pearson's chi-square test, Mantel-Haenszel test, Spearman rank correlation, and life-table methods (Kaplan-Meier curves, log-rank test, Cox proportional hazards model) as appropriate. Testosterone was analyzed both as a continuous factor and as low ( < 300 ng/dl) versus normal testosterone levels. Results: The median testosterone level was 423 ng/dl, median age was 65 years, and median follow-up was approximately 15 years. A significant association between testosterone values below 300 ng/dl and positive surgical margin ( p = 0.0389) as well as seminal vesicle invasion ( p = 0.0182) was found. While patients with a testosterone level < 300 ng/dl also showed a higher percentage of BCF over time (45% vs. 29% at 15 years), the difference was not statistically significant ( p = 0.076, log-rank test). When adjusted for known predictors of BCF (Gleason score, pre-RP prostate-specific antigen, seminal vesicle involvement, and positive surgical margin), the effect of testosterone as a continuous predictor was not statistically significant ( p = 0.57). Conclusion: The longest follow-up to date (15 years) correlating preoperative testosterone levels and RP outcomes is presented. With this study, low testosterone levels were significantly associated with a positive surgical margin and seminal vesicle invasion, and slightly higher ( p = 076) BCF rates.

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