Positive Association between Preoperative Total Testosterone and Lymph Node Invasion in Intermediate Risk Prostate Cancer

Antonio B Porcaro; Alessandro Tafuri; Marco Sebben; Paolo Corsi; Tania Processali; Marco Pirozzi; Davide De Marchi; Davide Inverardi; Maria A Cerruto; Nelia Amigoni; Riccardo Rizzetto; Matteo Brunelli; Roberto Iacovelli; Salvatore Siracusano; Walter Artibani; *Authors contributed equally to this work.

doi:10.1159/000499303

Positive Association between Preoperative Total Testosterone and Lymph Node Invasion in Intermediate Risk Prostate Cancer

Curr Urol. 2019 Jul;12(4):216-222. doi: 10.1159/000499303. Epub 2019 Jul 20.

Authors

Antonio B Porcaro¹, Alessandro Tafuri¹, Marco Sebben¹, Paolo Corsi¹, Tania Processali¹, Marco Pirozzi¹, Davide De Marchi¹, Davide Inverardi¹, Maria A Cerruto¹, Nelia Amigoni¹, Riccardo Rizzetto¹, Matteo Brunelli², Roberto Iacovelli³, Salvatore Siracusano¹, Walter Artibani¹; *Authors contributed equally to this work.

Affiliations

¹ Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy.
² Department of Pathology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy.
³ Department of Oncology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy.

Abstract

Introduction: Prostate cancer (PCa) patients who are classified into the intermediate risk category represent a heterogeneous population needing further preoperative risk assessment.

Objectives: To evaluate clinical total testosterone (TT) associations with lymph node invasion (LNI) in intermediate risk PCa.

Material and methods: Between November 2014 and July 2016, intermediate risk PCa was assessed in 154 patients who underwent extended pelvic lymph node dissection if the risk of LNI was higher than 5%. Clinical factors associated with the risk LNI were investigated by the multinomial logistic regression model.

Results: The risk of LNI was assessed higher than 5% in 40.9% of cases of whom 15.5% had LNI. In the multivariate model, the risk of LNI was independently increased by prostate specific antigen (OR = 1.185; p = 0.021) and TT (OR = 1.004; p = 0.036). As a result, TT was an independent factor that associated with LNI because it increased the risk of LNI by 4% for each increment unit of TT.

Conclusion: Preoperative TT independently increased the risk of LNI in the intermediate risk class of PCa patients elected to radical prostatectomy and extended pelvic lymph node dissection. TT might be a useful preoperative factor for stratifying intermediate risk patients because of the positive association of TT with high grade tumors.

Keywords: Lymph node invasion; Pelvic lymph node dissection; Prostate cancer; Prostate specific antigen; Radical prostatectomy; Testosterone.