MP09-19 LOW FREE TESTOSTERONE IS AN INDEPENDENT RISK FACTOR FOR HIGH GRADE PROSTATE CANCER

You have accessJournal of UrologyProstate Cancer: Staging I (MP09)1 Apr 2019MP09-19 LOW FREE TESTOSTERONE IS AN INDEPENDENT RISK FACTOR FOR HIGH GRADE PROSTATE CANCER Maxwell Towe*, Linda M. Huynh, Farouk M. El-Khatib, Mohamad Osman, Faysal A. Yafi, and Thomas Ahlering Maxwell Towe*Maxwell Towe* More articles by this author , Linda M. HuynhLinda M. Huynh More articles by this author , Farouk M. El-KhatibFarouk M. El-Khatib More articles by this author , Mohamad OsmanMohamad Osman More articles by this author , Faysal A. YafiFaysal A. Yafi More articles by this author , and Thomas AhleringThomas Ahlering More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000555143.35970.33AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: The role of testosterone in prostate growth and the development of prostate cancer is a controversial topic. Most current data suggest that lower testosterone leads to higher grade conversion, whereas higher testosterone may serve a protective role in preventing both development and recurrence. We seek to analyze whether free testosterone (FT) values can predict aggressiveness in prostate cancers. METHODS: We retrospectively reviewed 830 patients who presented to a single surgeon for evaluation and management of prostate cancer. FT values were obtained on each patient at initial visit. All patients underwent radical prostatectomy and samples from surgery were sent for grading and staging. Mean FT values for each Gleason score and stage were calculated and compared by in univariate and multivariate analysis. Patients were then stratified by FT quartile (25th [less than 4.42 ng/dL], 50th [4.43-5.60 ng/dL], 75th [5.61-6.95 ng/dL], and 100th [greater than 6.96 ng/dL]). RESULTS: Of 830 patients, 168 (22.2%), 330 (39.8%), 188 (22.7%), 46 (5.5%), and 98 (11.8%) had GS ≤3+3, 3+4, 4+3, 4+4, and ≥4+5, respectively. Mean FT values were significantly different in univariate analysis (p = 0.008). In terms of stage, 553 (66.1%), 272 (32.5%), and 11 (1.3%) were T2, T3, and T4 at presentation, respectively, and mean FT was also lower in patients with higher stage disease (p = 0.01). Figure 1 depicts proportion of Gleason grade by level of FT. Patients who had a FT level in the lowest quartile (≤4.42 ng/dL) had a higher proportion of Gleason grade group 5 (15.6%) than patients in the highest quartile (≥6.96 ng/dL) (6.2%) (p=0.002). After adjusting for age and PSA in multivariate analysis, lower FT was a significant predictor of high-risk score 9-10 (OR: 0.912, 95% CI: 0.836-0.994, p=0.036). These trends showed strong correlation in pathologic stage (p = 0.057), but larger numbers are needed to gauge effect size. CONCLUSIONS: Based on our data, biochemically low FT may be a risk factor for high grade and high stage cancer. These results have implications for the current recommendations for testosterone therapy, which is contraindicated in men with prostate cancer. Source of Funding: None Orange, CA© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e116-e116 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Maxwell Towe* More articles by this author Linda M. Huynh More articles by this author Farouk M. El-Khatib More articles by this author Mohamad Osman More articles by this author Faysal A. Yafi More articles by this author Thomas Ahlering More articles by this author Expand All Advertisement PDF downloadLoading ...