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KMID : 1001020200180020116
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Journal of Urologic Oncology
2020 Volume.18 No. 2 p.116 ~ p.123
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Serum Testosterone Level Can Be Predictive Factor for Upstaging in Clinically Localized Prostate Cancer
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Kwon Soon-Oh
Byeon Kyeong-Hyeon
Chung Jae-Wook
Ha Yun-Sok
Choi Seock-Hwan
Kim Bum-Soo
Kim Hyun-Tae
Kim Tae-Hwan
Yoo Eun-Sang
Yoon Ghil-Suk
Lee Jun-Nyung
Kwon Tae-Gyun
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Abstract
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Purpose: To determine an appropriate surgical technique, it is important to predict pathological results for patients with clinically localized prostate cancer (PCa) eligible for nerve-sparing radical prostatectomy (NSRP). Several studies have highlighted that serum testosterone level was associated with aggressive features of PCa. Therefore, we analyzed factors, including serum testosterone, to predict upstaging and upgrading after surgery for patients with clinically localized PCa eligible for NSRP.
Materials and Methods: We retrospectively evaluated patients who underwent radical prostatectomy (RP) between January 2015 and May 2018 at our institution. Patients with Gleason grade group 1 or 2 on biopsy, prostate-specific antigen<10, and ≤clinical/radiologic stage T2 were included in this study. Upstaging and upgrading were defined as pathological stage≥T3a and Gleason grade group≥3, respectively. We evaluated the patients’ demographics and outcomes according to upstaging and upgrading after surgery. Predictive factors for upstaging and upgrading were analyzed using a multivariate logistic regression model.
Results: Of 108 patients included in the study, upstaging and upgrading after surgery were observed in 24 (22.2%) and 36 (33.3%), respectively. Low serum testosterone level, small prostate size, and positive core number≥3 on biopsy were identified as predictive factors for upstaging in multivariate analysis. Although serum testosterone was associated with upgrading in univariate analysis, only clinical/radiologic stage and biopsy Gleason grade group were observed as predictive factors for upgrading in multivariate analysis.
Conclusions: Serum testosterone level was identified as a predictive factor for upstaging after RP for clinically localized PCa eligible for NSRP.
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KEYWORD
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Pathology, Prostate cancer, Prostatectomy, Testosterone, Treatment outcome
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