Preoperative Serum Sex Hormone-Binding Globulin Level Is an Independent Predictor of Biochemical Outcome After Radical Prostatectomy

Abstract

To investigate the significance of preoperative serum sex hormone-binding globulin (SHBG) level regarding the postoperative biochemical outcome in patients who were followed up for relative longer periods after undergoing radical prostatectomy (RP).Preoperative serum levels of testosterone (T), free T, and SHBG level were prospectively analyzed in 307 consecutive patients who underwent RP at our institution between January 2006 and July 2007. We analyzed potential associations of sex hormones with postoperative biochemical recurrence (BCR)-free survival via multivariate Cox proportional regression analysis.Mean postoperative follow-up duration for 307 total patients was 72.1 ± 19.6 months. Kaplan–Meier curve demonstrated that BCR-free survival was significantly worse in patients with higher (≥ 40 ng/mL) SHBG level than others (P < 0.001). Serum T (P = 0.280) and free T (P = 0.606) levels showed no significant association with biochemical outcome. In multivariate analysis encompassing postoperative variables along with PSA, T, and free T, SHBG level (HR 1.825, 1.061–3.138; P = 0.030) was observed to be independently associated with BCR-free survival. Addition of SHBG level to the multivariate model for prediction of BCR-free survival resulted in increased accuracy (83.5% vs. 82.2%; P = 0.164).Our study of patients who were followed up for relative longer periods after RP shows that preoperative serum SHBG level, but not T, is an independent predictor of postoperative BCR-free survival. According to our findings, SHBG measurement may be useful in the selection of candidates for adjuvant treatment following RP.

Research progress on the relationship between sex hormone‐binding globulin and male reproductive system diseases

“…SHBG produced by the liver is transported from the blood to the reproductive system and affects target organs through different pathways, leading diseases such as PCA, infertility, ED, and LOH Preoperative serum SHBG levels and SHBG polymorphisms can be used in the prognostic prediction of PCA. Lee et al (2015) confirmed that the survival rate was high in patients with high SHBG levels undergoing radical prostatectomy and that SHBG level could be used as an independent predictor of survival. SHBG levels can independently predict prostatic hyperplasia as a biomarker of tumour enlargement outside the prostate (Lee et al, 2008).…”

Evaluating the genetic effects of sex hormone traits on the development of mental traits: a polygenic score analysis and gene-environment-wide interaction study in UK Biobank cohort

“…Meanwhile, SHBG can assess bioavailable testosterone level [ 42 ]. Lee et al [ 43 ] have reported that serum SHBG level is an independent predictive factor for extraprostatic extension of tumor in prostate cancer patients. Higher SHBG concentrations were observed in the premenopausal women who consumed alcohol [ 44 ], which consistent with our result in females.…”

Evaluating the genetic effects of sex hormone on the development of mental traits: a polygenic score analysis and genome-wide genetic interaction analysis in the UK Biobank cohort

“…Meanwhile, SHBG can assess the bioavailable testosterone level [42]. Lee et al [43] have reported that serum SHBG level is an independent predictive factor for extraprostatic extension of tumor in prostate cancer patients. Higher SHBG concentrations were observed in the premenopausal women who consumed alcohol [44], which consistent with our result in females.…”