To evaluate the influence of endogenous testosterone density (ETD) and tumor load density (TLD) in the surgical specimen of prostate cancer (PCa) patients.
ETD was assessed as the ratio of endogenous testosterone (ET) to prostate volume (PV). TLD was calculated as the ratio of tumor load (TL) to prostate weight. Preoperative prostate-specific antigen relative densities (PSAD) and percentage of biopsy-positive cores (BPCD) were also assessed. The association of high TLD (above the first quartile) with clinical and pathological factors was assessed by the logistic regression model (univariate and multivariate analysis).
Between November 2014 and December 2019, ET was measured in 805 cases treated with radical prostatectomy (RP). Median (IQR) of ET and ETD was 412 (321.4-519 ng/dL) and 9.8 (6.8-14.4 ng/(dLxmL)) as well as for TL and TLD was 20 (10-30%) and 0.33 (0.17-0.58%/gr), respectively. As a result, high TLD was detected in 75% of cases. A positive independent association was found between high TLD and ETD. Accordingly, as ETD levels increased, the risk of detecting high TLD in the surgical specimen increased, regardless of PSAD and BPCD.
At diagnosis of PCa, a positive independent association was found between ETD and risk of high TLD. Subjects with increasing ETD levels were more likely to have high TLD, associated with unfavorable pathology features. The positive association between ETD and TLD in the prostate microenvironment might adversely influence PCa's natural history.
Urologia. 2023 Aug 01 [Epub ahead of print]
Antonio Benito Porcaro, Alberto Bianchi, Sebastian Gallina, Emanuele Serafin, Giovanni Mazzucato, Andrea Panunzio, Alessandro Tafuri, Francesca Montanaro, Giulia Marafioti Patuzzo, Alberto Baielli, Francesco Artoni, Stefano Vidiri, Francesco Cianflone, Damiano D'Aietti, Matteo Brunelli, Salvatore Siracusano, Maria Angela Cerruto, Alessandro Antonelli
Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy., Department of Urology, Vito Fazzi Hospital, Lecce, Italy., Department of Pathology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy., Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.