The relationship between total and free serum testosterone and the risk of prostate cancer and tumour aggressiveness

Moróte, Juan; Ramírez, Cristobal; Gómez, E. Martínez; Planas, Jacques; Raventós, Carles X.; Torres, Inés M. de; Catalán, Rosa

doi:10.1111/j.1464-410x.2009.08378.x

Cited by 39 publications

(37 citation statements)

References 24 publications

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“…Salonia et al 12 found an association between androgens and higher risk PCa that was not proven to be independent on multivariate analysis. Other studies showed no association, 12,24 while Porcaro et al suggest a direct relation between testosterone levels and Gleason score, a result that opposes the findings described previously. 25 In our study, we evaluated 423 patients and tested two thresholds, 250 and 300 ng/dL, for the definition of hypogonadism.…”

Section: Discussionmentioning

confidence: 61%

Low serum testosterone is a predictor of high-grade disease in patients with prostate cancer

Albuquerque

Guglielmetti

Barbosa³

et al. 2017

Rev. Assoc. Med. Bras.

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Objective: To evaluate the relation between serum total testosterone (TT) and prostate cancer (PCa) grade and the effect of race and demographic characteristics on such association. Method: We analyzed 695 patients undergoing radical prostatectomy (RP), of whom 423 had serum TT collected. Patients were classified as having hypogonadism or eugonadism based on two thresholds of testosterone: threshold 1 (300 ng/dL) and threshold 2 (250 ng/dL). We evaluated the relation between TT levels and a Gleason score (GS) ≥ 7 in RP specimens. Outcomes were evaluated using univariate and multivariate analyses, accounting for race and other demographic predictors. Results: Out of 423 patients, 37.8% had hypogonadism based on the threshold 1 and 23.9% based on the threshold 2. Patients with hypogonadism, in both thresholds, had a higher chance of GS ≥ 7 (OR 1.79, p=0.02 and OR 2.08, p=0.012, respectively). In the multivariate analysis, adjusted for age, TT, body mass index (BMI) and race, low TT (p=0.023) and age (p=0.002) were found to be independent risk factors for GS ≥ 7. Among Black individuals, low serum TT was a stronger predictor of high-grade disease compared to White men (p=0.02). Conclusion: Hypogonadism is independently associated to higher GS in localized PCa. The effect of this association is significantly more pronounced among Black men and could partly explain aggressive characteristics of PCa found in this race.

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Section: Discussionmentioning

confidence: 61%

Low serum testosterone is a predictor of high-grade disease in patients with prostate cancer

Albuquerque

Guglielmetti

Barbosa³

et al. 2017

Rev. Assoc. Med. Bras.

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“…Even though the association between T and erectile function has not been completely clarified [19][20] and the role of T in PCa development is still under investigation, 21,22 our study investigated the relationship between T and ED in men with PCa, before RP. Our data seem to be in agreement with the conclusions of Khera,23 suggesting that although the relationship between testosterone and improvement in erectile function should be well established, the role of testosterone in ED recovery after RP may be of even greater significance.…”

Section: Discussionmentioning

confidence: 99%

“…14 IIEF was used to better define the erectile function. The possible scores for the IIEF-5 range from 5 to 25, and ED was classified into five categories based on the scores: severe (5-7), moderate (8)(9)(10)(11), mild to moderate (12)(13)(14)(15)(16), mild (17)(18)(19)(20)(21) and no ED (22)(23)(24)(25). 15 …”

Section: Hrqol Measuresmentioning

confidence: 99%

Influence of serum testosterone on urinary continence and sexual activity in patients undergoing radical prostatectomy for clinically localized prostate cancer

Gacci

Corona

Apolone

et al. 2010

Prostate Cancer Prostatic Dis

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The aim of the present study was to evaluate how serum testosterone level (T) can affect urinary continence and erectile function in patients undergoing radical prostatectomy (RP). We included 257 patients with clinically localized prostate cancer, those who had filled out preoperative quality of life questionnaires (University of California, Los Angeles Prostate Cancer Index, International Index of Erectile Function (IIEF)), and those who had T and total PSA sampled the day before surgery. We calculated correlations between T and age, body mass index (BMI), PSA, urinary function or bother (UF, UB) and sexual function or bother (SF, SB) and IIEF-5 in the whole population and in sub-populations with normal (X10.4 nmol l À1 ) and low (o10.4 ng ml À1 ) T using Pearson's and Spearman's correlation coefficients. We evaluated differences in these parameters between patients with low and normal T using the unpaired samples t-test and Mann-Whitney test, and finally the correlation between UF and SF, UB and SB, and between PSA and T in the overall population, and separately in patients with low and normal T using the Pearson's correlation coefficient. Mean preoperative T was 13.5 nmol l À1 and 23.7% of patients presented a low T. Mean age, mean BMI and mean preoperative total PSA at RP were 64.3 years, 25.9 kg m À2 and 9.0 ng ml À1 , respectively. BMI was negatively correlated with T in the overall population (r ¼ À0.266; P ¼ 0.02); moreover, patients with normal T presented lower BMI compared with patients with low T (25.7 vs 27.6: P ¼ 0.02). We found a significant correlation between SF scores and T in patients with normal T (r ¼ 0.1777: P ¼ 0.05). SF was significantly higher in patients with normal T compared with those with low T (74.8 vs 64.8: P ¼ 0.05). Furthermore, UF and UB were significantly correlated with SF (r ¼ 0.2544: Po0.01) and SB (r ¼ 0.2512: P ¼ 0.01), respectively, in men with normal T. Serum T was significantly correlated with PSA in men with low T (r ¼ 0.3874: P ¼ 0.0029), whereas this correlation was missed in the whole population and in men with normal T. The correlation between preoperative PSA and T in men with low T is in agreement with the 'saturation' model proposed by Morgentaler. The correlation between basal T and preoperative erectile function and urinary continence underlines the importance of assessing T before RP.

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“…However, in a IGF-1 levels correlate with sexual dysfunction AW Pastuszak et al recent study of 478 men screened for prostate cancer with transrectal ultrasound-guided biopsy, no relationship was observed between serum testosterone level and prostate cancer severity. 43 Thus, it is possible that the relationship between testosterone level and Gleason score is indeed most significant in older men with more aggressive tumors. Our study was limited by several factors.…”

Section: Discussionmentioning

confidence: 99%

IGF-1 levels are significantly correlated with patient-reported measures of sexual function

et al. 2011

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Growth hormone (GH) supplementation may help to preserve erectile function. We assessed whether serum insulin-like growth factor 1 (IGF-1) levels, a surrogate for GH levels, correlate with sexual function scores in 65 men who completed the Sexual Health Inventory for Men (SHIM) and Expanded Prostate Cancer Index Composite (EPIC) questionnaires, and had serum IGF-1 and testosterone levels determined. Median±s.d. IGF-1 level, SHIM and EPIC scores were 235.0±86.4, 19.5 ± 8.7 and 56.4 ± 28.3 mg ml À1 , respectively. IGF-1 levels and total SHIM score correlate significantly (r ¼ 0.31, P ¼ 0.02), as do IGF-1 levels and all individual SHIM question scores, and IGF-1 levels and the sexual domain of the EPIC questionnaire (r ¼ 0.30, P ¼ 0.02). No correlation was observed between IGF-1 levels and Gleason score, IGF-1 and testosterone level or SHIM score and testosterone level. These data support a potential role for the GH axis in erectile function.

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The relationship between total and free serum testosterone and the risk of prostate cancer and tumour aggressiveness

Cited by 39 publications

References 24 publications

Low serum testosterone is a predictor of high-grade disease in patients with prostate cancer

Low serum testosterone is a predictor of high-grade disease in patients with prostate cancer

Influence of serum testosterone on urinary continence and sexual activity in patients undergoing radical prostatectomy for clinically localized prostate cancer

IGF-1 levels are significantly correlated with patient-reported measures of sexual function

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