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20. Anti-Müllerian hormone: a novel biomarker for aggressive prostate cancer? Emerging evidence from a prospective study of radical prostatectomies

Author

Kontogiannis, Stavros, Markantes, Georgios, Stamou, Maria, Tsagkarakis, Michail, Mamali, Irini, Giannitsas, Konstantinos, Perimenis, Petros, Georgopoulos, Neoklis, and Athanasopoulos, Anastasios

Abstract

Purpose: Prostate cancer patients are a heterogeneous group as regards the aggressiveness of the disease. The relationship of steroid hormones with the aggressiveness of prostate cancer is unclear. It is known that the anti-Müllerian hormone (AMH) inhibits prostate cancer cell lines in vitro. The aim of this study is to investigate the relationship of AMH and steroid hormones with the aggressiveness of prostate cancer. Methods: This was a prospective study of consecutive radical prostatectomy patients. We measured the following hormones: total testosterone, sex hormone-binding globulin, albumin, luteinizing hormone, follicle-stimulating hormone, estradiol, dehydroepiandrosterone sulfate, androstenedione, and AMH. The minimum follow-up after radical prostatectomy was 5 years. For the aggressiveness of prostate cancer, we considered the following three variables: post-operative Gleason score (GS) ≥ 8, TNM pΤ3 disease, and prostate-specific antigen (PSA) biochemical recurrence (BCR). Results: In total, 91 patients were enrolled. The mean age and PSA were 64.8 years and 9.3 ng/dl, respectively. The median post-operative GS was 7. Low AMH blood levels were correlated with higher post-operative GS (p= 0.001), as well as with PSA BCR (p= 0.043). With pT3 disease, only albumin was (negatively) correlated (p= 0.008). ROC analysis showed that AMH is a good predictor of BCR (AUC 0.646, 95% CI 0.510–0.782, p= 0.043); a cutoff value of 3.06 ng/dl had a positive prognostic value of 71.4% and a negative prognostic value of 63.3% for BCR. Cox regression analysis showed that AMH is a statistically significant and independent prognostic marker for BCR (p= 0.013). More precisely, for every 1 ng/ml of AMH rise, the probability for PSA BCR decreases by 20.8% (HR = 0.792). Moreover, in Kaplan–Meier analysis, disease-free survival is more probable in patients with AMΗ ≥ 3.06 ng/ml (p= 0.004). Conclusions: Low AMH blood levels were correlated with aggressive prostate cancer in this radical prostatectomy cohort of patients. Therefore, AMH could be a prognostic biomarker for the aggressiveness of the disease.

Published
2023
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24. Evaluating the social added value of LEADER: Evidence from a marginalised rural region.

Author

Chatzichristos, Georgios and Perimenis, Anastasios

Subjects
SOCIAL values, ETHICAL investments, RURAL development, SOCIAL distancing
Abstract

One of the most significant challenges in rebuilding Europe after COVID-19 is stimulating the marginalised, rural areas of the European Union (EU). Amid a social distancing environment, it is quite important to re-evaluate policy instruments that have recorded successes in rural development with an emphasis on the infrastructure of local dialogue; the Liaisons Entre Actions de Developpement de l'Economie Rurale (LEADER) has been such a programme. The current article introduces a qualitatively-integrated Social Return on Investment tool to evaluate the social added value of LEADER. The evaluation method was applied on the rural island of Lesvos in Greece. The evaluation results indicated that LEADER becomes a worthwhile investment when a wide range of its social outflows are taken into account. Additionally, in order to enhance its social value, a level of maturity and a solid economic basis must be first achieved. In this context, continuous monitoring and evaluation become crucial. • LEADER evaluation must be seen as a development challenge. • LEADER adds significant social value to rural areas. • LEADER should be seen as a multi-stage process. • To realise its potential, LEADER needs a solid economic basis. • Continuous monitoring and evaluation of the LEADER strategy is vital. [ABSTRACT FROM AUTHOR]

Published
2022
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