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Total testosterone density predicts high tumor load and disease reclassification of prostate cancer: results in 144 low-risk patients who underwent radical prostatectomy
- Publication Year :
- 2019
-
Abstract
- The aim of this study is to evaluate the association between total testosterone density (TTD), defined as the ratio of serum TT to prostate volume (PV), and high tumor load (HTL) in low-risk prostate cancer (PCA) patients who underwent radical prostatectomy.Tumor load was defined as the percentage of prostate volume invaded by cancer (PPI-PCA) in the surgical specimen. Pathologic features including tumor upgrading, upstaging or positive surgical margins in the specimen defined unfavorable disease (UD). PSA, TT, PSA density (PSAD), TTD, percentage of biopsy positive cores (BPC), PV and body mass index (BMI). The association of factors with the risk UD and HTL was evaluated by statistical methods.The cohort included 144 consecutive low-risk PCA patients. Overall, 104 patients (72.2%) had at least one feature indicating UD. TTD was associated with BMI, TT, PSA, PV and PPI-PCA ≥ 20% defined as HTL. A higher PPI-PCA was associated with an increased risk of UD with a fair discriminant power (area under the curve, AUC = 0.775; p 0.0001). Patients with PPI-PCA 20% were considered the study group versus patients with a PPI-PCA 20% (control group). BPC, PSAD and TTD were independently associated with the risk of HTL (PPI-PCA ≥ 20%) with receiver-operating characteristics (ROC) curves indicating the same discriminant power for BPC (AUC = 0.628; p = 0.013), PSAD (AUC = 0.611; p = 0.032) and TTD (AUC = 0.610; p = 0.032).Among low-risk PCA patients, TTD is associated with the risk of HTL, which is an independent predictor of UD and should be evaluated in the management of these patients.
- Subjects :
- Male
medicine.medical_specialty
Urology
medicine.medical_treatment
030232 urology & nephrology
030204 cardiovascular system & hematology
Total testosterone
Prostate volume
03 medical and health sciences
Prostate cancer
0302 clinical medicine
Predictive Value of Tests
Risk Factors
Prostate
Biopsy
medicine
Humans
Testosterone
Aged
Retrospective Studies
Prostatectomy
Low-risk prostate cancer
medicine.diagnostic_test
business.industry
Area under the curve
Prostatic Neoplasms
Cancer
Middle Aged
medicine.disease
Tumor Burden
medicine.anatomical_structure
Nephrology
Cohort
Testosterone density
business
Body mass index
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....20b7e9164985a613ce3022add9aa6bf4