Editorial Comment

Abstract

The holy grail in PCa is to differentiate the relatively small number of tumors that will ultimately cause patient death from the large number of tumors that are unlikely to result in metastatic disease or eventual patient death. A key success factor would be a simple, inexpensive, readily available laboratory test, such as %FT. Albisinni et al provide intriguing findings in this regard. They reported that among 812 Italian men who underwent PCa biopsy, the %FT was increased in Gleason score 7 and greater tumors and neither testosterone nor free testosterone was associated with PCa development. In particular, men in the greatest %FT tertile had a significant twofold increased risk of high-grade PCa (95% CI 1.23-3.37). Although the findings are based on a single-site evaluation, the blood tests and biopsy and pathology protocols were all standardized, although only 1 sample was used to classify the hormonal concentrations. Greater Percent-free Testosterone Is Associated With High-grade Prostate Cancer in Men Undergoing Prostate BiopsyUrologyVol. 80Issue 1PreviewTo analyze the serum androgen concentrations in men who underwent an initial prostate biopsy, focusing on the percent-free testosterone (%FT) as a predictor of low- and high-grade prostate cancer (PCa). Most studies have suggested that the absolute serum testosterone and free testosterone levels are not related to PCa risk. However, to date, the concurrent effect of free and total testosterone levels has not been evaluated. In particular, the association of the %FT (free testosterone/total testosterone) with PCa risk has not been explored. Full-Text PDF