MP82-15 HYPOGONADISM IS ASSOCIATED WITH A REDUCED RISK OF HIGH GRADE PROSTATE CANCER

Abstract

You have accessJournal of UrologyProstate Cancer: Detection & Screening VII1 Apr 2018MP82-15 HYPOGONADISM IS ASSOCIATED WITH A REDUCED RISK OF HIGH GRADE PROSTATE CANCER Cosimo De Nunzio, Francesco Esperto, Riccardo Lombardo, Mariangela Bellangino, Antonio Nacchia, Angela Sica, Fabiana Cancrini, and Andrea Tubaro Cosimo De NunzioCosimo De Nunzio More articles by this author , Francesco EspertoFrancesco Esperto More articles by this author , Riccardo LombardoRiccardo Lombardo More articles by this author , Mariangela BellanginoMariangela Bellangino More articles by this author , Antonio NacchiaAntonio Nacchia More articles by this author , Angela SicaAngela Sica More articles by this author , Fabiana CancriniFabiana Cancrini More articles by this author , and Andrea TubaroAndrea Tubaro More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2743AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Aim of our study was to explore the risk of prostate cancer and poorly differentiated prostate cancer (PCa) in hypogonadal men undergoing prostate biopsies. METHODS From 2008 onwards, a consecutive series of men undergoing 12-core prostate biopsy at one center in Italy were enrolled into a prospective database. Indications for prostatic biopsy were PSA value = 4 ng/ml and/or a positive digital rectal examination (DRE). Blood samples were collected before biopsy and tested for: total PSA levels, SHBG, serum testosterone level. Hypogonadism was defined as serum Testosterone levels < 2.3 ng/ml.We evaluated the association between hypogonadism status and prostate cancer risk and biopsy Gleason score using logistic regression analyses. RESULTS Overall 1124 patients were enrolled. Median age was 68 years (IQR: 62/63), median BMI was 27 kg/m2 (IQR: 25/29); median PSA 6.2 ng/ml (IQR: 4.4/9.0); median testosterone level was 3.8 ng/ml (IQR: 3.0/4.8), median SHBG 40 mmol/l (IQR 30/53). Overall 460/1124 (40.9%) had cancer on biopsy and out of them 126/460 presented a high grade disease (Gleason score =4+3).185/1124 (16%) of patients were hypogonadal. Prostate cancer detection was 380/939 (40.5%) in eugonadal patients and 80/185 (43.2%) in hypogonadal men (p=0.267). High grade prostate cancer was observed in 111/380 (29.2%) in eugonadal men and 15/80 (19%) in hypogonadal men (p=0.002). On multivariate analysis age (OR: 1.046 95%CI: 1.030-1.063; p= 0.000) and PSA (OR: 1.068 95%CI: 1.046-1.091; p= 0.000) were the only independent parameters associated with prostate cancer diagnosis while no difference was observed regarding the hypogonadal state. On multivariate analysis age (OR: 1.044 95%CI: 1.017-1.072; p= 0.000) and PSA (OR: 1.030 95%CI: 1.015-1.045; p= 0.000) were associated with high grade prostate cancer diagnosis while the presence of hypogonadal state reduced the risk of high grade PCa by 60% (OR: 0.40, IC 0.25-0.84, p=0.012). CONCLUSIONS In our study about 16% of patients at risk of PCa were hypogonadal. Hypogonadism was associated with a reduced risk of high grade prostate cancer. Although further studies should evaluate the pathophysiology behind this association, we support that hormonal status should be evaluated in patients at risk of PCa. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e1112 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Cosimo De Nunzio More articles by this author Francesco Esperto More articles by this author Riccardo Lombardo More articles by this author Mariangela Bellangino More articles by this author Antonio Nacchia More articles by this author Angela Sica More articles by this author Fabiana Cancrini More articles by this author Andrea Tubaro More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...