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Positive Association between Preoperative Total Testosterone and Lymph Node Invasion in Intermediate Risk Prostate
Antonio B Porcaro1, Alessandro Tafuri1, Marco Sebben1
1Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy.
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.
