Low serum total testosterone level as a predictor of upgrading in low-risk prostate cancer patients after radical prostatectomy: A systematic review and meta-analysis
Investigative and Clinical Urology 2022³â 63±Ç 4È£ p.407 ~ p.414
(Gan Shu) - Guangzhou University of Chinese Medicine Second Affiliated Hospital Department of Urology
(Liu Jian) - Xinfeng County People¡¯s Hospital of Jiangxi Province Department of Urology
(Chen Zhiqiang) - Guangzhou University of Chinese Medicine Second Affiliated Hospital Department of Urology
(Xiang Songtao) - Guangzhou University of Chinese Medicine Second Affiliated Hospital Department of Urology
(Gu Chiming) - Guangzhou University of Chinese Medicine Second Affiliated Hospital Department of Urology
(Li Siyi) - Guangzhou University of Chinese Medicine Second Affiliated Hospital Department of Urology
(Wang Shusheng) - Guangzhou University of Chinese Medicine Second Affiliated Hospital Department of Urology
Abstract
Purpose: To investigated the association between serum total testosterone and Gleason score upgrading of low-risk prostate cancer after radical prostatectomy (RP).
Materials and Methods: Medline, Web of Science, Embase, and Cochrane Library databases were searched to identify eligible studies published before October 2021. Multivariate adjusted odds ratios (ORs) and associated 95% confidence intervals (CIs) were calculated using random or fixed effects models.
Results: Five studies comprising 1,203 low-risk prostate cancer patients were included. The results showed that low serum total testosterone (<300 ng/dL) is associated with a high rate of Gleason score upgrading after RP (OR, 2.3; 95% CI, 1.38?3.83; p<0.001; I2, 92.2%). Notably, sensitivity and meta-regression analyses further strengthen the reliability of our results.
Conclusions: Our results support the idea that low serum total testosterone is associated with a high rate of Gleason score upgrading in prostate cancer patients after RP. It is beneficial for urologist to ensure close monitoring of prostate-specific antigen levels and imaging examination when choosing non-RP treatment for low-risk prostate cancer patients.
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Meta-analysis, Prostatectomy, Prostatic neoplasms, Testosterone
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In conclusion, low preoperative serum total testosterone is associated with a high rate of Gleason score upgrading in prostate cancer patients after RP.