998 IN 538 GLEASON 7 DERIVED FROM RADICAL PROSTATECTOMY, GRADE 4+3 IS MORE FREQUENT THAN 3+4 IN HYPOGONADIC PATIENTS

Abstract

You have accessJournal of UrologyProstate Cancer: Localized (IV)1 Apr 2013998 IN 538 GLEASON 7 DERIVED FROM RADICAL PROSTATECTOMY, GRADE 4+3 IS MORE FREQUENT THAN 3+4 IN HYPOGONADIC PATIENTS Yann Neuzillet, Jean-Pierre RAYNAUD, Vincent MOLINIE, Camelia RADULESCU, Thierry LEBRET, and Henry BOTTO Yann NeuzilletYann Neuzillet Suresnes, France More articles by this author , Jean-Pierre RAYNAUDJean-Pierre RAYNAUD Paris, France More articles by this author , Vincent MOLINIEVincent MOLINIE Paris, France More articles by this author , Camelia RADULESCUCamelia RADULESCU Suresnes, France More articles by this author , Thierry LEBRETThierry LEBRET Suresnes, France More articles by this author , and Henry BOTTOHenry BOTTO Suresnes, France More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.582AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Fifteen percent of patients who underwent radical prostatectomy have hypogonadism defined as a total testosterone less than 3 ng/ml. Low testosterone (lowT) serum level in prostate cancer patients before treatment is associated with poor prognosis. Moreover, there is accumulating evidences that Gleason 7 prostate cancer shows heterogeneous behavior with Gleason 3 + 4 and 4 + 3 tumors conferring different prostate cancer specific mortality. The aim of this observational study was to characterize the aggressiveness of the prostate cancer assessed by the predominant Gleason pattern (pGP), in relation to preoperative testosterone serum concentration. METHODS 786 patients, referred to our Department (from 03/2007 to 09/2012) for a radical prostatectomy, had preoperative TT and Bioavailable Testosterone (samplings between 7 and 10 am) serum determinations (radio-immuno assayed in a central laboratory). GS and pGP was determined in prostate biopsies and prostate tissue specimens. RESULTS In prostate specimens, a GS7 was observed in 538 (68.4%) of the patients; 195 (24.8%) had a pGP4. Comparing the 195 patients with a pGP4 to the 343 with a pGP3, TT was lower (4.23±1.63 vs. 4.73±1.70 ng/mL, p=0.0009) and PSA higher (10.2 vs. 8.0 ng/mL, p<0.0001). Hypogonadism was more frequent (26% vs. 9%, p=0.0003). Extra prostatic extension was more frequently observed (22.5% versus 10.5%, p=0.0002). The 80 patients with TT <3.0 ng/mL were bigger (+8kg, p<0.0001) with a BMI highier (+ 2.7 kg/m2, p<0.0001). They had a higher percent of GS with a pGP4: 55.0% vs. 33.0% (p=0.0002). CONCLUSIONS The pGP in prostate specimens is of paramount importance, especially in case of a Gleason 7, to appreciate the outcomes and to choose the treatment. In cancer Gleason 7 in radical prostatectomy specimens, pGP4 is more frequent in hypogonadal patients. Preoperative testosterone should be used to improve the management of prostate cancer. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e409-e410 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Yann Neuzillet Suresnes, France More articles by this author Jean-Pierre RAYNAUD Paris, France More articles by this author Vincent MOLINIE Paris, France More articles by this author Camelia RADULESCU Suresnes, France More articles by this author Thierry LEBRET Suresnes, France More articles by this author Henry BOTTO Suresnes, France More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...