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Endogenous testosterone mirrors prostate cancer aggressiveness: correlation between basal testosterone serum levels and prostate cancer European Urology Association clinical risk classes in a large cohort of Caucasian patients

  • Urology - Original Paper
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Abstract

Objective

To evaluate the association between basal total testosterone (TT) levels with the European Association of Urology (EAU) risk classes at the time of diagnosis of prostate cancer (PCA).

Methods

A retrospective review of prospectively collected data was carried out between November 2014 and March 2018. Preoperative basal TT levels and PSA were measured in 601 consecutive Caucasian patients who were not under androgen deprivation and undergoing surgery at a tertiary referral center. Patients were classified into low (reference group), intermediate- and high-risk/locally advanced classes. The multinomial logistic regression model evaluated associations of TT and other clinical factors with EAU risk classes.

Results

One hundred twenty four patients (24%) were low risk, 316 (52.6%) were intermediate, 199 (16.5%) were high risk and 42 (7%) were locally advanced. Median circulating basal TT levels increased along EAU classes. TT, PSA, percentage of biopsy-positive cores and tumor clinical stage were independently associated with the high-risk class (odds ratio, OR = 1.002; p = 0.030) but were not associated with intermediate-risk or locally advanced PCA when compared to the low-risk class. TT above the median value was an independent predictor of high-risk class PCA.

Conclusions

Basal TT levels are positively associated with low, intermediate and high EAU risk classes. The association is significant for the high-risk class when compared to the low-risk group, but was lost in locally advanced risk class. In PCA patients, high TT serum levels are associated with high-risk disease. Endogenous TT should be considered as a biological marker for assessing EAU PCA risk classes.

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Funding

The authors did not receive financial support.

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Author notes

  1. Alessandro Tafuri and Marco Sebben authors contributed equally to this manuscript.

Authors and Affiliations

  1. Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Piazzale Stefani 1, 37126, Verona, Italy

    Alessandro Tafuri, Marco Sebben, Marco Pirozzi, Tania Processali, Riccardo Rizzetto, Nelia Amigoni, Filippo Migliorini, Salvatore Siracusano, Maria Angela Cerruto, Walter Artibani, Alessandro Antonelli & Antonio B. Porcaro

  2. USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA

    Alessandro Tafuri & Aliasger Shakir

  3. Department of Pathology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy

    Matteo Brunelli

Authors
  1. Alessandro Tafuri
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Contributions

A Tafuri: project development, data collection, data analysis and interpretation, manuscript writing. M Sebben: data collection, data interpretation, manuscript writing. AB Porcaro: project development, data analysis and interpretation, manuscript writing. A Shakir: manuscript writing and language and critical revision. M Pirozzi, T Processali, N Amigoni, R Rizzetto: data collection. M Brunelli, F Migliorini, MA Cerruto, S Siracusano, A. Antonelli, W Artibani: other (supervision and critical revision).

Corresponding author

Correspondence to Antonio B. Porcaro.

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Tafuri, A., Sebben, M., Shakir, A. et al. Endogenous testosterone mirrors prostate cancer aggressiveness: correlation between basal testosterone serum levels and prostate cancer European Urology Association clinical risk classes in a large cohort of Caucasian patients. Int Urol Nephrol 52, 1261–1269 (2020). https://doi.org/10.1007/s11255-020-02398-x

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