Endogenous testosterone density as ratio of endogenous testosterone levels on prostate volume predicts tumor upgrading in low-risk prostate cancer
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Published:2021-10-22
Issue:12
Volume:53
Page:2505-2515
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ISSN:0301-1623
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Container-title:International Urology and Nephrology
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language:en
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Short-container-title:Int Urol Nephrol
Author:
Porcaro Antonio BenitoORCID, Gallina Sebastian, Bianchi Alberto, Cerrato Clara, Tafuri Alessandro, Rizzetto Riccardo, Amigoni Nelia, Orlando Rossella, Serafin Emanuele, Gozzo Alessandra, Migliorini Filippo, Antoniolli Stefano Zecchini, Lacola Vincenzo, De Marco Vincenzo, Brunelli Matteo, Cerruto Maria Angela, Siracusano Salvatore, Antonelli Alessandro
Abstract
Abstract
Objectives
To evaluate preoperative endogenous testosterone (ET) density (ETD), defined as the ratio of ET on prostate volume, and tumor upgrading risk in low-risk prostate cancer (PCa).
Materials and methods
From November 2014 to December 2019, 172 low-risk patients had ET (nmol/L) measured. ETD, prostate-specific antigen density (PSAD) and the ratio of percentage of biopsy positive cores (BPC) to prostate volume (PV), defined as BPC density (BPCD), were evaluated. Associations with tumor upgrading in the surgical specimen were assessed by statistical methods.
Results
Overall, 121 patients (70.3%) had tumor upgrading, which was predicted by BPCD (odds ratio, OR = 4.640; 95% CI 1.903–11.316; p = 0.001; overall accuracy: 70.3%). On multivariate analysis, tumor upgrading and clinical density factors related to each other for BPCD being predicted by ETD (regression coefficient, b = 0.032; 95% CI 0.021–0.043; p < 0.0001), PSAD (b = 1.962; 95% CI 1.067–2.586; p < 0.0001) and tumor upgrading (b = 0.259; 95% CI 0.112–0.406; p = 0.001). According to the model, as BPCD increased, ETD and PSAD increased, but the increase was higher for upgraded cases who showed either higher tumor load but significantly lower mean levels of either ET or PSA.
Conclusions
As ETD increased, higher tumor loads were assessed; however, in upgraded patients, lower ET was also detected. ETD might stratify low-risk disease for tumor upgrading features.
Funder
Università degli Studi di Verona
Publisher
Springer Science and Business Media LLC
Subject
Urology,Nephrology
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