Circulating estradiol, but not testosterone, is a significant predictor of high-grade prostate cancer in patients undergoing radical prostatectomy - Abstract

Department of Urology, University Vita-Salute San Raffaele, Milan, Italy.


The objective of this study was to assess the association between preoperative circulating levels of 17β-estradiol (E(2) ) and high-grade prostate cancer (HGPCa) (Gleason grade ≥4 + 3) at the time patients underwent radical retropubic prostatectomy (RRP).

Serum total testosterone (tT), sex hormone-binding globulin (SHBG), and E(2) levels were measured the day before surgery (8-10 AM) in a cohort of 655 consecutive Caucasian- European patients who underwent RRP at a single institution. Logistic regression models were used to test the association between predictors (including age, body mass index, prostate-specific antigen [PSA], clinical tumor classification, biopsy Gleason sum, tT, SHBG, and E(2) ) and HGPCa. Serum E(2) was included in the model as both a continuous variable and a categorized variable (according to the most informative cutoff: 50 pg/mL).

Pathologic HGPCa was identified in 156 patients (23.8%). Patients with HGPCa had significantly higher PSA, clinical tumor classification, and biopsy Gleason sum than those without HGPCa (all P < .001). No other significant differences were observed between groups. At univariate analysis, continuously coded E(2) was not associated significantly with HGPCa (odds ratio [OR], 1.009; P = .25), whereas patients with E(2) levels ≥50 pg/mL had a 3.24-fold increased risk of HGPCa (P < .001). At multivariate analysis, E(2) was associated significantly with HGPCa both as a continuous predictor (OR, 1.02; P = .04) and as a categorical predictor (OR, 3.94; P < .001) after accounting for other variables. Conversely, tT and SHBG levels were not associated significantly with HGPCa.

E(2) was associated significantly with pathologic HGPCa, whereas SHBG and tT failed to demonstrate any association with HGPCa in patients who underwent RRP.

Written by:
Salonia A, Gallina A, Briganti A, Suardi N, Capitanio U, Abdollah F, Bertini R, Freschi M, Rigatti P, Montorsi F.   Are you the author?

Reference: Cancer. 2011 Apr 14. Epub ahead of print.
doi: 10.1002/cncr.26136

PubMed Abstract
PMID: 21495024 Prostate Cancer Section



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