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Clinical implications of endogenous testosterone density on prostate cancer progression in patients with very favorable low and intermediate risk treated with radical prostatectomy

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Asian Journal of Andrology 2023年第5期25卷 556-563页

作者： Antonio Benito Porcaro Alessandro Tafuri andrea panunzio Clara Cerrato Alberto Bianchi Sebastian Gallina Stefano Vidiri Damiano D'Aietti Emanuele Serafin Giovanni Mazzucato Alessandro Princiotta Davide Brusa Matteo Brunelli Vincenzo Pagliarulo Maria Angela Cerruto AlessandroAntonelli Department of Urology University of VeronaIntegrated University Hospital of VeronaVerona 37126Italy Department of Urology Vito Fazzi HospitalLecce 73100Italy Department of Pathology University of VeronaIntegrated University Hospital of VeronaVerona 37126Italy

We tested the association between endogenous testosterone density(ETD;the ratio between endogenous testosterone[ET]and prostate volume)and prostate cancer(PCa)aggressiveness in very favorable low-and intermediate-risk PCa patients who underwent radical prostatectomy(RP).Only patients with prostate-specific antigen(PSA)within 10 ng ml^(-1),clinical stage T1c,and International Society of Urological Pathology(IsUP)grade group 1 or 2 were *** ET levels up to 350 ng dl^(-1)were classified as *** quantitation density factors were evaluated as the ratio between percentage of biopsy-positive cores and prostate volume(biopsy-positive cores density,BPCD)and the ratio between percentage of cancer invasion at final pathology and prostate weight(tumor load density,TLD).Disease upgrading was coded as ISUP grade group>2,and progression as recurrence(biochemical and/or local and/or distant).Risk associations were evaluated by multivariable Cox and logistic regression *** 320 patients,151(47.2%)had intermediate-risk ***(median:402.3 ng dl^(-1))resulted abnormal in 111(34.7%)cases(median ETD:9.8 ng dl^(-1)ml^(-1)).Upgrading and progression occurred in 109(34.1%)and 32(10.6%)cases,*** was predicted by ISUP grade group 2(hazard ratio[HR]:2.290;P=0.029)and upgrading(HR:3.098;P=0.003),which was associated with ISUP grade group 2(odds ratio[OR]:1.785;P=0.017)and TLD above the median(OR:2.261;P=0.001).After adjustment for PSAdensity and bodymass index(BMI),ETDabovethemedianwas positivelyassociatedwithBPCD(OR:3.404;P<0.001)and TLD(OR:5.238;P<0.001).Notably,subjects with abnormal ET were more likely to have higher BPCD(OR:5.566;P=0.002),as well as TLD(OR:14.998;P=0.016).Independently by routinely evaluated factors,as ETD increased,BPCD and TLD increased,but increments were higher for abnormal ET *** very favorable cohorts,ETD may further stratify the risk of aggressive PCa.

关键词： endogenous testosterone density prostate cancer radical prostatectomy tumor progression

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The association of type and number of high-risk criteria with cancer-specific mortality in prostate cancer patients treated with radical prostatectomy

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Current Urology 2024年第2期18卷 128-132页

作者： Francesco Chierigo Rocco Simone Flammia GabrieleSorce Benedikt Hoeh Lukas Hohenhorst andrea panunzio Zhe Tian Fred Saad Marcus Graefen Michele Gallucci Alberto Briganti Francesco Montorsi Felix K.H.Chun Shahrokh F.Shariat Alessandro Antonelli Giovanni Guano Guglielmo Mantica Marco Borghesi Nazareno Suardi Carlo Terrone Pierre I.Karakiewicz Department of Surgical and Diagnostic Integrated Sciences University of GenovaGenovaItaly IRCCS Ospedale Policlinico San Martino GenovaItaly Cancer Prognostics and Health Outcomes Unit Division of UrologyUniversity ofMontréal Health CenterMontréalQuébecCanada Department of Urology IRCCS Policlinico San MartinoGenovaItaly Department of Maternal-Child and Urological Sciences Sapienza Rome UniversityPoliclinico Umberto I HospitalRomeItaly Department of Urology University Hospital FrankfurtFrankfurt am MainGermany Martini-Klinik Prostate Cancer Center University Hospital Hamburg-EppendorfHamburgGermany Department of Urology University of VeronaAzienda Ospedaliera Universitaria Integrata di VeronaVeronaItaly Division of Experimental Oncology/Unit of Urology URIUrological Research InstituteIRCCS San Raffaele Scientific InstituteMilanItaly Department of Urology Comprehensive Cancer CenterMedical University of ViennaViennaAustria Department of Urology Weill Cornell Medical CollegeNew YorkNYUSA Department of Urology University of Texas SouthwesternDallasTXUSA Department of Urology Second Faculty of MedicineCharles UniversityPragueCzech Republic Institute for Urology and Reproductive Health I.M.Sechenov First Moscow State Medical UniversityMoscowRussia Division of Urology Department of Special SurgeryJordan University HospitalThe University of JordanAmmanJordan

Objectives:This study aimed to test the association between of type and number of D'Amico high-risk criteria(DHRCs)with cancer-specific mortality(CSM)in high-risk prostate cancer patients treated with radical *** and methods:In the Surveillance,Epidemiology,and End Results database(2004–2016),we identified 31,281 radical prostatectomy patients with at least 1 DHRC,namely,prostate-specific antigen(PSA)>20 ng/mL(hrPSA),biopsy Gleason Grade Group(hrGGG)score of 4 and 5,or clinical tumor stage≥T3(hrcT).Multivariable Cox regression models and competing risks regression models(adjusting for other cause mortality)tested the association between DHRCs and 5-year ***:Of 31,281 patients,14,394(67%)exclusively harbored hrGGG,3189(15%)harbored hrPSA,and 1781(8.2%)harbored *** 2132 patients(6.8%)harbored a combination of the 2 DHRCs,and 138(0.6%)had all 3 ***-year CSMrates ranged from 0.9%to 3.0%when any individual DHRC was present(hrcT,hrPSA,and hrGGG,in that order),1.6%to 5.9%when 2 DHRCs were present(hrPSA-hrcT,hrcT-hrGGG,and hrPSA-hrGGG,in that order),and 8.1%when all 3 DHRCs were *** regression models and competing risks regression confirmed the independent predictor status of DHRCs for 5-year CSM that was observed in univariable analyses,with hazard ratios from 1.00 to 2.83 for 1 DHRC,2.35 to 5.88 for combinations of 2 DHRCs,and 7.13 for all 3 ***:Within individual DHRCs,hrcT and hrPSA exhibited weaker effects than hrGGG ***,a dose-response effect was identified according to the number of ***,the type and number of DHRCs allow further risk stratification within the high-risk subgroup.

关键词： High risk prostate cancer Radical prostatectomy Cancer-specific mortality Staging SEER

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