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Prostate cancer volume associates with preoperative plasma levels of testosterone that independently predicts high grade tumours which show low densities(quotient testosterone/tumour volume)

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Asian Journal of Urology 2016年第1期3卷 26-32页

作者： Antonio B.Porcaro Aldo Petrozziello Matteo Brunelli Filippo Migliorini Giovanni Cacciamani Davide de Marchia nicolo’de luyk Irene Tamanini Beatrice Caruso Maria A.Cerruto Claudio Ghimenton Walter Artibani Clinica Urologica Ospedale Policlinico ed Ospedale Civile MaggioreAzienda Ospedaliera Universitaria IntegrataVeronaItaly Medicina Interna/Endocrinologia Ospedale Policlinico ed Ospedale Civile MaggioreAzienda Ospedaliera Universitaria IntegrataVeronaItaly Anatomia Patologica Ospedale Policlinico ed Ospedale Civile MaggioreAzienda Ospedaliera Universitaria IntegrataVeronaItaly Medicina di Laboratorio Ospedale Policlinico ed Ospedale Civile MaggioreAzienda Ospedaliera Universitaria IntegrataVeronaItaly

Objective:To investigate potential associations of preoperative total testosterone(TT)with tumor volume(TV)and grade of prostate cancer(PCa).Methods:Patients who were under medications impacting on the hypothalamic-pituitaryadrenal-testis-prostate axis were *** was measured preoperatively at least 1 month after biopsies and TV was calculated on the removed prostate *** continuous variables included total prostate specific antigen(PSA),percentage of positive cores(Pt)and weight(W)of the removed *** were categorized according to the pathologic Gleason score(pGS)in 3 groups(pGS 6,7 and>7).Invasion of the seminal vesicles was coded as seminal vesicle invasion(SVI).Results:The median levels of TT were significantly and increasingly higher from pGS 6(14.7 nmol/L)to pGS 7(15.0 nmol/L)and pGS>7(18.8 nmol/L).The median values of TV were also detected significantly and increasingly higher from pGS 6(5.6 mL)to pGS 7(8.1 mL)and pGS>7(14.8 mL).The median preoperative levels of PSA were also increasing from pGS 6(5.9 μg/L)to pGS 7(6.2 μg/L)and pGS>7(7.7 μg/L).There was a significant and positive correlation of TV to PSA,TT and *** linear regression analysis showed that TV was significantly and independently predicted by TT,PSA and *** grade PCa(pGS>7)independently associated with TV,TT,Pt and *** median density values of TT relative to TV(quotient TT/TV)significantly decreased from pGS 6(2.6 nmol/L/mL)to pGS 7(1.9 nmol/L/mL)and pGS>7(1.4 nmol/L/mL).The median density values of PSA relative to TV(quotient PSA/TV)also significantly decreased from pGS(1.1 μg/L/mL)to pGS 7(0.7 μg/L/mL)and pGS>7(0.6 μg/L/mL).Conclusion:The investigation shows that TT relates to volume and grade of PCa;moreover,the density of TT relative to TV inversely associates with rate of increase of cancer that depends on the grade of the tumour.

关键词： Total testosterone Tumour volume Prostate-specific antigen Prostate cancer Pathology Gleason score

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Robotic assisted radical prostatectomy accelerates postoperative stress recovery: Final results of a contemporary prospective study assessing pathophysiology of cortisol peri-operative kinetics in prostate cancer surgery

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Asian Journal of Urology 2016年第2期3卷 88-95页

作者： Antonio B.Porcaro nicolo`de luyk Paolo Corsi Marco Sebben Alessandro Tafuri Davide Inverardi Davide de Marchi Irene Tamanini Matteo Brunelli Maria Angela Cerruto Gian Luca Salvagno Gian Cesare Guidi Walter Artibani Urologic Clinic University HospitalOspedale PoliclinicoAzienda Ospedaliera Universitaria IntegrataVeronaItaly department of Pathology University HospitalOspedale PoliclinicoAzienda Ospedaliera Universitaria IntegrataVeronaItaly department of Laboratory Medicine University HospitalOspedale PoliclinicoAzienda Ospedaliera Universitaria IntegrataVeronaItaly

Objective:To investigate the effects of prostate cancer(PCa)surgery on the stress system and to identify potential independent factors associating with stress ***:The design of the study was prospective and PCa surgery included robot assisted radical prostatectomy(RARP)or retropubic radical prostatectomy(RRP).Between February 2013 to december 2014,315 consecutive patients were *** effects of PCa surgery on the stress system were measured by cortisol serum levels before and after surgery on postoperative day(POD)0,1,3,5 and *** variations in the population and subpopulation(RARP ***)of patients were investigated by statistical *** associating with stress recovery were assessed by simple linear regression(SLR)and multiple linear regression(MLR)***:RARP was performed in 75.9%of *** the patient population,there were wide serum cortisol perioperative *** surgery triggered the stress system which immediately(POD 0)responded by cortisol overproduction which induced the negative feedback mechanism that started on POD 1,continued on POD 3,was still ongoing on POD 5 and completely settled on POD 45(stress recovery).In the subpopulation of patients,significantly lower cortisol serum levels were detected on POD 3e5 in RARP cases inwhomcortisol levels were close to preoperative levels(stress recovery)on POD *** predictive factors of serum cortisol on POD 5(stress recovery)were preoperative cortisol(p Z 0.02),cortisol levels on POD 3(pdence that the RARP procedure associates with stress recovery

关键词： Prostate cancer Robot assisted radical prostatectomy Retropubic radical prostatectomy Stress system

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