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BJU Int. 2012 Feb;109(4):520-4. doi: 10.1111/j.1464-410X.2011.10335.x. Epub 2011 Aug 18.

Serum testosterone level as a predictor of biochemical failure after radical prostatectomy for localized prostate cancer.

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Department of Urology and The Finsen Laboratory, Rigshospitalet, University of Copenhagen, Denmark.



• To investigate serum testosterone levels as a predictor for biochemical failure (BF) after radical retropubic prostatectomy (RRP).


• Prospective cohort study with 227 patients and a median follow-up of 7.7 years. • Total serum testosterone was measured at diagnosis. • Primary endpoint: 5-year BF-free survival defined as first PSA > 0.2 ng/mL. • Testosterone was tested as a predictor of BF as a dichotomized and continuous variable.


• Median (range) age was 62 years (45-74), median PSA 9.9 ng/mL (0.4-96), and median testosterone was 14 nmol/L (2.2-40). • BF occurred for 57 patients (26%) within 5 years. • In multivariate analysis with age, PSA, and biopsy Gleason score, testosterone levels >11 nmol/L were an independent predictor for reduced risk of BF (hazard ratio, 0.53; 95% confidence interval, 0.31-0.90; P= 0.02). • When analyzed as a continuous variable, testosterone was not a statistically significant predictor of BF.


• Low pretreatment serum testosterone levels correlate with a higher risk of BF, and testosterone may possess biological information about prostate cancer progression potential, which makes it an independent predictor of biochemical failure after RRP.

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