The Relationship Between Pre-Radiation Therapy Testosterone Levels And Prostate Cancer Aggressiveness

We investigated whether there is an association between testosterone levels and prostate cancer aggressiveness in patients treated with radiation therapy who underwent a prostatectomy or prostate radiotherapy (EBRT). A total of 380 patients who received primary or post-operative radiotherapy were identified. At the time of radiotherapy, baseline testosterone levels and body mass index (BMI) measurements were available. On multivariate analysis (MVA), higher prostate-specific antigen (PSA) levels were predictive of testosterone >= 10.4 (OR = 1.3,p = .04) and testosterone >= 12.0 nmol/L (OR = 1.3,p = .04). Patients with a Gleason score >= 8 were more likely to have testosterone <8 nmol/L than patients with a lower score (31% vs. 20%,p = .043). On univariate analysis, a Gleason score >= 8 was associated with a lower likelihood of having a normal (>= 8 nmol/L) testosterone level (OR = 0.51, 95% CI: 0.3-0.9,p = .02), and on MVA adjusted for post-surgical versus primary EBRT and BMI (>= 30 kg/m(2)), the Gleason score lost its statistical significance (p = .09). While higher PSA levels are associated with higher testosterone levels, the interaction between Gleason score and testosterone is unclear and merits further study.