PURPOSE: To assess the association between preoperative serum total testosterone (tT), 17β-estradiol (E2), sex hormone-binding globulin (SHBG), and tT-E2ratio values with high-risk prostate cancer (as defined by the National Comprehensive Cancer Network practice guidelines) at radical prostatectomy.
EXPERIMENTAL DESIGN: Serum E2, tT, and SHBG were dosed the day before surgery (7:00-11:00 am) in a cohort of 724 candidates to radical prostatectomy. Restricted cubic spline functions tested the association between predictors (i.e., model 1: age, body mass index, and serum tT, E2, and SHBG levels; model 2: tT-E2 values instead of tT and E2 levels) and high-risk prostate cancer.
RESULTS: Low-, intermediate-, or high-risk prostate cancer was found in 251 (34.7%), 318 (43.9%), and 155 (21.4%) patients, respectively. Patients in the high-risk class showed the lowest tT, E2, and tT-E2 ratio values (all P ≤ 0.02). At univariate analysis, only age, tT, E2, and tT-E2 ratio values were significantly associated with high-risk prostate cancer (all P ≤ 0.006). At multivariate analyses considering model 1 variables, age (P = 0.03), serum tT (all P < 0.001), and E2 (all P ≤ 0.01) were associated with high-risk prostate cancer; only tT-E2 ratios achieved independent predictor status for high-risk prostate cancer (all P < 0.001) when considering model 2. Both the lowest and the highest tT, E2, and tT-E2 values depicted a nonlinear U-shaped significant association with high-risk prostate cancer.
CONCLUSIONS: These data showed that preoperative serum sex steroids are independent predictors of high-risk prostate cancer, depicting a nonlinear U-shaped association.
Salonia A, Abdollah F, Capitanio U, Suardi N, Briganti A, Gallina A, Colombo R, Ferrari M, Castagna G, Rigatti P, Montorsi F. Are you the author?
Department of Urology, University Vita-Salute San Raffaele, Milan, Italy.
Reference: Clin Cancer Res. 2012 Jun 4. Epub ahead of print.