MP80-12 ASSOCIATION BETWEEN HIGH PREOPERATIVE SERUM TOTAL TESTOSTERONE LEVELS IN OBESITY PATIENTS AND PSA RECURRENCE AFTER ROBOTIC-ASSISTED LAPAROSCOPIC RADICAL PROSTATECTOMY AMONG JAPANESE POPULATION

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP80-12 ASSOCIATION BETWEEN HIGH PREOPERATIVE SERUM TOTAL TESTOSTERONE LEVELS IN OBESITY PATIENTS AND PSA RECURRENCE AFTER ROBOTIC-ASSISTED LAPAROSCOPIC RADICAL PROSTATECTOMY AMONG JAPANESE POPULATION Yutaka Horiguchi, Kiichi Hagiwara, Noboru Sakamoto, Fumio Tsukuda, Toshikazu Okaneya, and Shoji Koga Yutaka HoriguchiYutaka Horiguchi More articles by this author , Kiichi HagiwaraKiichi Hagiwara More articles by this author , Noboru SakamotoNoboru Sakamoto More articles by this author , Fumio TsukudaFumio Tsukuda More articles by this author , Toshikazu OkaneyaToshikazu Okaneya More articles by this author , and Shoji KogaShoji Koga More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003357.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Although a relationship between prostate cancer pathology and prognosis and serum total testosterone (TT) has been studied, previous evidences were contradictory. Also, there are few reports on the relationship between TT and oncologic outcomes after robotic-assisted laparoscopic radical prostatectomy (RARP). While, the influence of a high body mass index (BMI) on prostate cancer risk has been suggested. Therefore, we prospectively investigated the relationship between preoperative TT and postoperative PSA recurrence (BCR) in patients who underwent RARP. METHODS: A total of 1060 prostate biopsies were performed in our hospital between July 2015 and November 2020. Of 666 patients diagnosed with prostate cancer, 238 underwent RARP. The study cohort were 233 patients who had been followed up for more than 6 months after surgery. TT measurements were performed at 6:00 early morning on admission to all patients for prostate biopsy. A BCR was defined as postoperative PSA ≥0.2 ng/mL. RESULTS: The median age, serum PSA level, and TT at diagnosis were 70 (41 - 80) years, 8.56 (3.23 - 113.86) ng/mL, and 4.15 (0.73 - 10.70) ng/mL, respectively. RARP was performed at a mean of 2.5 (1.2 - 6.3) months after biopsy, and the mean postoperative follow-up period was 47 (6 - 86) months. Median TT level 12 months after RARP was 114% of preoperative TT in randomely evaluated 30 patients. BCR was observed in 54 patients (23.2%) at an average of 17 (0 - 65) months after surgery and salvage radiation and/or androgen deprivation therapy were applied. On Cox proportional hazard model multivariate analysis, significant preoperative predictors of BCR were biopsy Grade Group (bGG) ≥4 (Hazard ratio (HR) 3.3, p<0.0001), clinical stage T classification (cT) ≥ 3 (HR 2.3, p=0.003), and PSA density (PSAD) ≥ 0.25 (HR 2.2, p=0.014). When the patients are stratified by BMI ≥ 26.0 (n=57, 24.5% of study cohort, median TT: 3.51 ng/mL), bGG and cT lost their significance; instead, TT ≥ 3.78 ng/mL (HR 3.9, p=0.021) and PSAD ≥ 0.25 (HR 5.0, p=0.035) were significant predictors. When a risk of BCR was classified according to these 2 factors, only 1 of 17 patients (5.8%) in the low-risk (0 factor) group had BCR, whereas 9 of 14 (64.3%) patients in the high-risk (2 factors) group had BCR (Log-rank test, p<0.001). CONCLUSIONS: Preoperative TT was a significant independent factor for predicting BCR after RARP in patients with BMI ≥ 26.0 among Japanese population, indicating its usefulness when considering the treatment options prior to RARP. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1156 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Yutaka Horiguchi More articles by this author Kiichi Hagiwara More articles by this author Noboru Sakamoto More articles by this author Fumio Tsukuda More articles by this author Toshikazu Okaneya More articles by this author Shoji Koga More articles by this author Expand All Advertisement PDF downloadLoading ...