Preoperative sex steroids are significant predictors of early biochemical recurrence after radical prostatectomy

We sought the association of preoperative serum total testosterone (tT), hypogonadism, 17 beta estradiol (E-2), and sex hormone-binding globulin (SHBG) with early biochemical recurrence (BCR) after radical prostatectomy (RP). Sex steroids were assessed the day before surgery (7-11 a.m.) in a cohort of 605 patients with a median follow-up of 24 months following RP. Cox regression models tested the association between predictors [including age, body mass index (BMI), prostate-specific antigen (PSA), clinical stage, biopsy Gleason scores, tT, hypogonadism, E-2, and SHBG] and early BCR (defined as a PSA a parts per thousand yen 0.1 ng/ml that occurred within 24 months after RP). Early BCR was found in 34 (5.6 %) patients. Patients with BCR did not differ in terms of age, BMI, serum PSA, tT, E-2, and SHBG levels, rate of hypogonadism, and clinical stage as compared with those without BCR (all p a parts per thousand yen 0.05). Conversely, patients with BCR showed a greater prevalence of biopsy Gleason scores a parts per thousand yen4 + 3 (all p a parts per thousand currency sign 0.001). At multivariable Cox regression analysis, tT [hazard ratio (HR): 1.43; p = 0.03] E-2 (HR: 1.05; p = 0.04), SHBG (HR: 1.29; p = 0.02), and biopsy Gleason scores equal to 4 + 3 (HR: 3.37; p = 0.04) and a parts per thousand yen8 (HR: 20.06; p < 0.001) achieved independent predictor status for early BCR. Conversely, no significant associations were found for all the other predictors. Current findings show that preoperative serum sex steroids are independent predictors of early BCR in a homogeneous, large cohort of nonscreened patients treated with RP.