Low Serum Testosterone Levels Associated with Worse Prostate Cancer Outcome

By Will Boggs, MD

NEW YORK DEC 29, 2005 (Reuters Health) - Low serum testosterone levels are associated with a greater likelihood of positive surgical margins in radical retropubic prostatectomy for prostate cancer, according to a report, subtitled "Hypogonadism Represents Bad Prognosis in Prostate Cancer," in the December issue of The Journal of Urology.

"We have to study more and more to understand the real meaning between low testosterone and prostate cancer," Dr. Carlos Teodosio Da Rosa from Santa Casa Hospital, Porto Alegre, Brazil told Reuters Health.

Dr. Da Rosa and colleagues investigated the association between serum total testosterone levels and prognostic factors in 64 patients with localized prostate cancer who underwent radical retropubic prostatectomy.

Nearly 40% of men with low testosterone had positive margins in their surgical specimens, the authors report, compared with 14.6% of patients with normal testosterone.

Mean serum testosterone levels were significantly lower in men with positive margins (284.7 ng/dL) than in men with negative margins (385.7 ng/dL), the report indicates.

In contrast, Gleason scores, pathological stage, capsular perforation, and seminal vesicle involvement did not differ in men with normal or low testosterone.

"Since low testosterone may predict positive surgical margins, it is reasonable to suppose that it would represent a different prognosis in patients who undergo radical retropubic prostatectomy," the investigators conclude. "As a consequence, these patients are more prone to present with prostate cancer recurrence and to require adjuvant treatment."

Dr. Da Rosa cautioned that changes in therapy are not yet indicated. "The management of these patients is not different from the others, because there is no answer about the meaning of this relationship, between poor prognosis and low levels of testosterone," he said.

SOURCE:

• J Urol 2005;174:2178-2180.