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The relationship between total and free serum testosterone and the risk of prostate cancer and tumour aggressiveness
BJU International, 02/18/09

Morote J et al. - In a trial to analyse the relationship between levels of total and free serum testosterone and risk of prostate cancer and tumour aggressiveness, it was found that prostate cancer risk and tumour aggressiveness are not related to serum levels of total and free testosterone, but hypogonadal pts do not have a greater risk of prostate cancer and tumour aggressiveness.

Methods

Total and free serum testosterone were determined in 478 pts consecutively assessed by transrectal ultrasonography-guided prostate biopsy because of an abnormal digital rectal examination and/or serum prostate-specific antigen (PSA) level of >4.0 ng/mL.
Tumour aggressiveness was assessed according to serum PSA level, biopsy Gleason score, and clinical stage in the subset of 216 pts with cancer (45.2%).
Prostate cancer risk and tumour aggressiveness were also compared in 80 hypogonadal pts (16.7%) and 398 eugonadal pts (83.3%).

Results

Median total serum testosterone level in pts without and with prostate cancer was 466.0 and 466.5 ng/dL, respectively; median levels of free serum testosterone were 9.9 and 10.0 pg/mL, respectively.
Cancer detection rate in hypogonadal pts was 41.3% (33/80) and 46.0% in eugonadal pts (183/398).
Median level of total testosterone was 433 ng/dL in pts with low-risk prostate cancer, 467 ng/dL in those with intermediate-risk tumours, and 468 ng/dL in those with high-risk tumours.
Median levels of free testosterone were 9.4, 9.8, and 10.3 pg/mL, respectively.

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