Pre- and post-radical prostatectomy testosterone levels in prostate cancer patients

Radical prostatectomy is one of the treatment of choices for localized prostate cancer. Published data show that radical prostatectomy is associated with both an increase and decrease in testosterone levels. This study aimed to document the changes in pre- and postoperative serum testosterone levels after radical prostatectomy along with the associations between serum testosterone levels and prostate cancer profiles in Thai population. Localized and locally advanced prostate cancer patients who elected to have radical prostatectomy without prior androgen deprivation therapy were included in the study. Patients' demographic data, pre- and postoperative serum testosterone levels, sex hormone binding globulin, albumin, prostate-specific antigen, and final pathologic reports were collected. Eighty-five prostate cancer patients were included in this study. Mean age was 67.32 years. Mean pre- and postoperative serum testosterone levels were 424.95 ng/dL and 371.94 ng/dL, respectively (p-value < 0.001). There was a greater testosterone reduction in patients with a final pathologic report of Gleason 4 + 3 and above compared with those with a Gleason 3 + 3 and 3 + 4 (p-value = 0.001). No significant association between preoperative testosterone levels and final Gleason scores was observed. This study documented significant postoperative testosterone reductions in prostate cancer patients after a radical prostatectomy. Patients with high Gleason grades had greater testosterone reductions. These findings may have clinical implications for the prediction of postoperative hypogonadal states in prostate cancer patients.