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Author Spotlight: Advancing Prostate Cancer Research Through Improved Tissue Sampling and Biobanking
Published on: November 17, 2023
707
Elevated periprostatic venous testosterone correlates with prostate cancer progression after radical prostatectomy
Mohammad Alyamani1, Patrick Michael1,2, Daniel Hettel1,2
1Genitourinary Malignancies Research Center, Lerner Research Institute.
The Journal of Clinical Investigation
|September 1, 2023
Summary
Men with higher local testosterone (T) levels in the prostate area had worse outcomes after prostate cancer surgery. This suggests local T exposure impacts prostate cancer progression.
Area of Science:
- Endocrinology
- Urology
- Oncology
Background:
- Clinical assessment of gonadal testosterone (T) typically relies on peripheral blood levels.
- Prostatic T exposure is assumed to mirror peripheral levels, despite androgens driving prostate cancer.
- Peripheral T has not been clinically utilized for localized prostate cancer evaluation or treatment.
Purpose of the Study:
- To investigate the role of local androgen delivery in prostate cancer.
- To compare dorsal vein testosterone (DT) levels with peripheral blood (PT) and prostatic tissue T concentrations.
- To assess the association between the DT/PT ratio and progression-free survival post-prostatectomy.
Main Methods:
- Blood samples were collected from the prostatic dorsal venous complex of 266 men undergoing radical prostatectomy.
- Comprehensive targeted steroid and metabolomics analyses were performed.
- The association between the DT/PT ratio and progression-free survival was evaluated.
Main Results:
- Some men exhibited significantly enriched DT levels compared to PT levels (up to 2-fold higher in 20%).
- Enrichment of isocaproic acid and 17-OH-progesterone in dorsal veins suggested testicular shunting.
- Elevated DT levels correlated with higher rates of prostate cancer recurrence and predicted worse outcomes.
Conclusions:
- A significant proportion of men experience unappreciated, undiluted exposure to concentrated prostatic testosterone.
- Elevated periprostatic T exposure is linked to adverse clinical outcomes following radical prostatectomy.
- These findings highlight the clinical relevance of local T measurements in prostate cancer management.
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