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Changes in the levels of testosterone profile over time in relation to clinical parameters in a cohort of patients with prostate cancer managed by active surveillance

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Abstract

Objectives

To characterize testosterone profile changes over time in a cohort of prostate cancer (PCa) patients managed with active surveillance (AS) and to assess its correlation with the initial disease characteristics and further progression.

Methods

We conducted retrospective chart review of PCa patients managed with AS. Patients were followed with PSA, total, free and bioavailable testosterone measurements, physical examination, and by repeat biopsies or periodic magnetic resonance imaging. Disease progression was identified by follow-up biopsy changes or by imaging. A Cox proportional hazard regression models were used to assess the association between testosterone profile at baseline and the risk of progression.

Results

For the 122 patients included in analyses, the mean age at diagnosis was 65.8 years; the mean follow-up time was 7.8 years. At baseline, 108 (88.5%) patients had a Gleason score of ≤ 6. In all, 45 (36.8%) patients had disease progression, with a mean time to progression of 4.6 years. During follow-up, PSA levels showed a rising trend, while testosterone profile levels showed a trend of decrease over time. There was no significant correlation between PSA and testosterone profile (total, free, and bioavailable) level changes over time (ρ = − 0.14, − 0.11 and − 0.16, P = 0.16, 0.34, and 0.20, respectively). In addition, multivariable analysis showed that serum-free testosterone was an independent predictor of disease progression (HR 0.93, 95% CI 0.88–0.99, P = 0.029).

Conclusion

Our study results showed that testosterone profile measurements tended to decrease over time in PCa patients managed with AS. Free testosterone was a significant independent variable of disease progression.

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Authors and Affiliations

  1. Division of Urology, Department of Surgery, McGill University, Montreal, Quebec, Canada

    Ahmed S. Zakaria, Alice Dragomir, Wassim Kassouf, Simon Tanguay & Armen Aprikian

Authors
  1. Ahmed S. Zakaria
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  2. Alice Dragomir
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  3. Wassim Kassouf
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  4. Simon Tanguay
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  5. Armen Aprikian
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Contributions

Zakaria AS: project development, data collection, data analysis, and manuscript writing. Dragomir A: project development, data analysis, and manuscript writing. Kassouf W: project development and manuscript writing. Tanguay S: project development and manuscript writing. Aprikian A: project development, data analysis, and manuscript writing.

Corresponding author

Correspondence to Armen Aprikian.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional and/or National Research Committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required (retrospective study).

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Zakaria, A.S., Dragomir, A., Kassouf, W. et al. Changes in the levels of testosterone profile over time in relation to clinical parameters in a cohort of patients with prostate cancer managed by active surveillance. World J Urol 36, 1209–1217 (2018). https://doi.org/10.1007/s00345-018-2270-2

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  • DOI: https://doi.org/10.1007/s00345-018-2270-2

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