TY - JOUR
T1 - Association of preoperative testosterone levels with biochemical failure in men undergoing radical prostatectomy
AU - Bruner, Bryan
AU - Nehra, Ajay
AU - Rangel, Laureano
AU - Bailey, Chris
AU - Bergstralh, Eric
AU - Blute, Michael
AU - Karnes, R. Jeffrey
N1 - Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.
PY - 2013
Y1 - 2013
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.
KW - hypogonadism
KW - prostate cancer
KW - sexual medicine
KW - urology
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U2 - 10.1089/jomh.2013.0016
DO - 10.1089/jomh.2013.0016
M3 - Article
AN - SCOPUS:84893039622
SN - 1875-6867
VL - 10
SP - 129
EP - 133
JO - Journal of Men's Health
JF - Journal of Men's Health
IS - 4
ER -