Serum testosterone as a biomarker for second prostatic biopsy in men with negative first biopsy for prostatic cancer and PSA&gt;4ng/mL, or with PIN biopsy result

Fiamegos, Alexandros; Varkarakis, John; Kontraros, M.; Karagiannis, A.; Chrisofos, Michael; Barbalias, D.; Deliveliotis, Ch.

doi:10.1590/s1677-5538.ibju.2015.0167

Cited by 6 publications

(5 citation statements)

References 35 publications

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“… 6 23 24 Recently, Fiamegos et al . 5 showed that patients with a positive re-biopsy after HGPIN had higher free testosterone and bioavailable testosterone levels than patients with negative re-biopsy. In our study, we related an association between higher TS levels and PCa at the second biopsy ( P < 0.001).…”

Section: Discussionmentioning

confidence: 97%

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The role of the serum testosterone levels as a predictor of prostate cancer in patients with atypical small acinar proliferation at the first prostate biopsy

Dell’Atti¹,

Galosi

2018

Asian J Androl

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The current literature does not support the usefulness of clinical markers on predicting which patients with atypical small acinar proliferation (ASAP) are more likely to progress to prostate cancer (PCa). Androgens have long been considered to be the potential risk factors for PCa. However, the role of testosterone is controversial. The present study aims to analyze the relationship between serum testosterone (TS) levels and the diagnosis of PCa after a first prostate biopsy in patients affected by ASAP. This retrospective study included 143 patients diagnosed with ASAP in an initial transrectal ultrasound-guided prostate biopsy for suspicious PCa according to the European Association of Urology guidelines. Their TS levels, age, PSA, prostate volume, digital rectal examination, and prostate biopsy Gleason score (GS) were collected retrospectively for statistical analysis. All patients included in the study had a second biopsy and were suitable for further analysis. Re-biopsy was carried out 3–6 months after the first diagnosis of ASAP. Low and normal TS groups were composed of 29 (20.3%) and 114 (79.7%) patients, respectively. The diagnosis of the second biopsy was ASAP in 25.2% and PCa in 36.4% of patients. The comparison between patients with PCa and those with negative or an ASAP result in the second biopsy reported that men with cancer had significantly higher levels of TS (P < 0.001). However, there was no statistically significant association between GS postbiopsy and TS (P = 0.324). Our experience demonstrated that eugonadal patients may be a clinical risk factor for the diagnosis of PCa on re-biopsy after ASAP diagnosis than hypogonadal.

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Section: Discussionmentioning

confidence: 97%

“… 1 4 The role of testosterone is controversial. 5 6 Testosterone levels are required for the normal growth and development of the prostate gland. 7 In many observational studies, high levels of testosterone have long been considered to be potential risk factors for PCa.…”

Section: Introductionmentioning

confidence: 99%

The role of the serum testosterone levels as a predictor of prostate cancer in patients with atypical small acinar proliferation at the first prostate biopsy

Dell’Atti¹,

Galosi

2018

Asian J Androl

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“…The clinical importance of recognizing HGPIN is based on its strong association with PCa, so its identification in biopsy specimens warrants further search for concurrent invasive carcinoma. Follow-up biopsy is suggested at 3 to 6 months for 2 years, and thereafter at 12 month intervals for life ( 18 ). Nevertheless, no factors seem to be useful in identifying which patients with HGPIN are at risk of PCa progression.…”

Section: Discussionmentioning

confidence: 99%

The impact of metformin use on the risk of prostate cancer after prostate biopsy in patients with high grade intraepithelial neoplasia

Dell’Atti¹,

Galosi

2018

Int. braz j urol.

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PurposeWe report our experience on metformin use in diabetic patients and its impact on prostate cancer (PCa) after a high-grade prostatic intraepithelial neoplasia (HGPIN) diagnosis.Materials and MethodsWe retrospectively analyzed 551 patients with a diagnosis of HGPIN without PCa in a first prostate biopsy. The cohort of the study consisted of 456 nondiabetic subjects, and 95 diabetic patients. Among the patients with diabetes 44 were treated with metformin, and 51 with other antidiabetic drugs. A transrectal ultrasound prostate biopsy scheme with 22 cores was carried out 4-6 months after the first diagnosis of HGPIN.ResultsAmong 195 (35.4%) patients with cancer, there were statistically significant differences in terms of PCa detection (p<0.001), Gleason score distribution (p<0.001), and number of positive biopsy cores (p<0.002) between metformin users and non-users. Metformin use was associated with a decreased risk of PCa compared with neveruse (p<0.001). Moreover, increasing duration of metformin assumption (≥2 years) was associated with decreasing incidence of PCa and higher Gleason score ≥7 compared with assumption <2 years.ConclusionsThis preliminary experience suggests that metformin use may have some beneficial effects in patients with diabetes and HGPIN; metformin should not be overlooked in these patients because it is neither new nor expensive.

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“…[11][12][13] Although recent studies have shown endogenous testosterone and growth hormone in the aging male to predict prostate disorders and to be potential risk factors for PC development after negative biopsies, FSH levels as potential protective or risk factors for developing PC have not been studied. [14][15][16] The objective of this study was to evaluate FSH levels in the general population and determine if there is an association between FSH levels and risk of PC diagnosis. Given FSH's role in the HGPA and its negative feedback mechanism, as well as the results of these studies showing high testosterone associated with PC development, our hypothesis was that low FSH levels would be associated with a decreased risk of subsequent PC diagnosis.…”

Section: Introductionmentioning

confidence: 99%

“…Although recent studies have shown endogenous testosterone and growth hormone in the aging male to predict prostate disorders and to be potential risk factors for PC development after negative biopsies, FSH levels as potential protective or risk factors for developing PC have not been studied 14–16 . The objective of this study was to evaluate FSH levels in the general population and determine if there is an association between FSH levels and risk of PC diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Are higher pre‐diagnosis follicle stimulating hormone levels associated with long‐term prostate cancer risk?

et al. 2022

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Background: Follicle stimulating hormone (FSH) is a pituitary hormone that helps regulate testosterone homeostasis. Although it is generally accepted that FSH levels increase with LHRH-agonist therapy for prostate cancer (PC), the specific impact of FSH levels on risk of PC diagnosis is largely unknown. The objective of this study was to perform a population-level analysis to assess the association between FSH levels and PC diagnosis. Methods: All men (n = 386,018) who had a pre-PC diagnosis FSH level and complete data were identified within the Veterans Affairs Health System between 1999 and 2018. The association between FSH level and time from FSH test to PC diagnosis was tested using stratified Cox proportional hazards models. Multivariable models were adjusted for age, year, race, body mass index, and Charlson comorbidity index. Due to nonproportional hazards over time, time to PC was modeled separately: ≤4 years after an FSH test and >4 years following an FSH test. Results: Median age at first FSH level was 64 years (interquartile range [IQR]: 54-72), median year of FSH was 2010 (IQR: 2005-2014), and 70% of the cohort was white. Median follow-up was 76 months (IQR: 38-126) during which 17,519 men (4.5%) were diagnosed with PC. On multivariable analysis, in the first 4 years after FSH test, there was no association between FSH and time to PC diagnosis.Starting from 4 years after FSH test, on multivariable analysis, a higher FSH level was associated with lower risk of PC with continuous modeling, but found no association with log continuous and categorical modeling. Conclusions:In this population-level study among male veterans receiving an FSH test for an unknown clinical indication, associations between FSH levels and PC risk were inconsistent and likely driven by selection bias and confounding variables.Future studies should consider different study designs.

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Serum testosterone as a biomarker for second prostatic biopsy in men with negative first biopsy for prostatic cancer and PSA>4ng/mL, or with PIN biopsy result

Cited by 6 publications

References 35 publications

The role of the serum testosterone levels as a predictor of prostate cancer in patients with atypical small acinar proliferation at the first prostate biopsy

The role of the serum testosterone levels as a predictor of prostate cancer in patients with atypical small acinar proliferation at the first prostate biopsy

The impact of metformin use on the risk of prostate cancer after prostate biopsy in patients with high grade intraepithelial neoplasia

Are higher pre‐diagnosis follicle stimulating hormone levels associated with long‐term prostate cancer risk?

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