125 The Relationship Between PSA and Total Testosterone Levels in Men with Low, Intermediate and High Grade Prostate Cancer

Abstract

PSA secretion is a testosterone (T) dependent process. Data suggests that low serum total T levels are an independent predictor of higher stage, higher grade prostate cancer. However, the link between men diagnosed with intermediate (I) and high-grade (HG) prostate cancer (PC), PSA values and T deficiency (TD) has not been explored before. The aim of this study was to evaluate the relationship between T and PSA in patients with I and HGPC. All men diagnosed with prostate cancer who underwent a RP since 2000 constituted the study population, who had a record of a morning total T (TT) level measured. Patients were subdivided based on prostate cancer pathology: Gleason 6/7 with favorable pathology; Gleason 6/7 with unfavorable pathology [seminal vesicle invasion (SVI), positive margins (PM), and positive lymph node involvement (LN)]; and Gleason ≥8 (irrespective of pathology). Demographic, clinical and pathological data were analyzed. Baseline PSA levels were evaluated and patients were divided according to their pre-treatment PSA group levels: 0-2; 2.1-4; >4 ng/ml. PSA, as a predictor of total T (TT) levels was evaluated in an ordinal and continuous fashion. T levels were measured before noon using LCMS at a single laboratory, drawn within ± 30 days of RP. Low T was defined as total TT <300 ng/dL; very low T as TT < 200 ng/dl.