Objective:

In this study, patients hormonally evaluated before prostate needle biopsy were considered among the ones who underwent radical prostatectomy (RRP) due to prostate adenocarcinoma and had locally advanced pathological stage (T3). The relationship between pathology results and cancer prognosis with hormonal data was investigated in these patients.

Materials and Methods:

Patients with hormonal data and those who were diagnosed with locally advanced prostate cancer were evaluated in two groups. Patients with T3a and T3b pathological stages were evaluated as group 1 and group 2, respectively. Prostate specific antigen (PSA), free PSA (fPSA), total testosterone (TTE), free testosterone (FTE), luteinizing hormone (LH), follicle stimulating hormone (FSH) and estradiol (EST) values of patients were examined. Prostate needle biopsy pathological data, prostate volume (PV), clinical stage, RRP pathological data, pathological stage, surgical margins and lymph node positivity and biochemical recurrence rates of patients were also evaluated. Then fPSA/PSA, PSA/PV, TTE/PV, TTE/FTE, TTE/LH, FSH/LH, TTE/FSH and TTE/EST ratios were calculated from the hormonal data. Finally, all data were compared between group 1 and group 2.

Results:

Thirty-two patients with hormonal data were retrospectively evaluated. Patient mean follow-up time was 31.9 months and there were 24 patients in group 1 and 8 patients in group 2. EST (p=0.05) and FSH/LH (p=0.044) values were identified to be higher in group 2. Also, prostate biopsy Gleason score (p=0.026) and perineural invasion positivity (p=0.024) were higher in group 2. Tumor volume (p=0.004), surgical margin positivity (p=0.022) and biochemical recurrence (p<0.001) rates from postoperative data were found to be higher in group 2, as well.

Conclusion:

In conclusion, higher rates of EST and FSH/LH values determined by hormonal evaluation before prostate needle biopsy were found to be associated with high-stage tumor, high surgical margin positivity and high biochemical recurrence after RRP. Therefore, hormonal evaluation can be used as a predictor of locally advanced disease.

Keywords: Extraprostatic extension, seminal vesicle invasion, testosterone, locally advanced prostate cancer, biochemical recurrence