Skip to main content
SpringerLink
Log in

Serum 17β-estradiol fails as a marker in identification of aggressive tumour disease in patients with localized prostate cancer

  • Original Article
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Abstract

Background

There is evidence that obesity is associated with an aggressive prostate cancer (PC). Furthermore, preclinical studies suggest that oestrogens may play a pivotal role in this context. The biological processes underlying these observations are not fully understood. We prospectively evaluated whether obesity and/or preoperative estradiol levels are associated with high-grade cancer in patients with clinically localized PC at the time they underwent radical retropubic prostatectomy (RRP).

Methods

Preoperative sex hormone serum 17β-estradiol (E2) as well as body mass index (BMI) and waist circumference (WC) were assessed in a cohort of 746 consecutive men treated with RP from February 2011 to October 2014. The data were correlated with patient-specific and clinicopathologic variables.

Results

A total of 746 patients underwent RRP. Median age was 68.0 years. Median E2 serum level was 18.3 ng/l (IQR 12.9–24.2 ng/l). Median BMI was 26.6 kg/m2 (IQR 24.6–29.1 kg/m2), and the median WC was 103 cm (IQR 96–110 cm). Serum E2 below or above the normal range was not found more frequently in obese patients (high BMI: p = 0.62; large WC: p = 0.83). E2 was not associated with BMI in our cohort of patients (r = 0.07, p = 0.10) or WC (r = 0.07, p = 0.10). There was no association between preoperative serum E2 levels and tumour stage (p = 0.86, Fisher’s exact), tumour grade (p = 0.37), lymph node involvement (p = 0.59) or Gleason score (p = 0.44). However, obesity correlated with tumour stage and grade (p = 0.036, Fisher’s exact) and nodal metastasis (p = 0.039, Fishers’ exact).

Conclusion

Pretreatment serum 17β-estradiol (E2) cannot be considered as a suitable marker for aggressive tumour disease in patients with localized prostate cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Center MM, Jemal A, Lortet-Tieulent J, Ward E, Ferlay J, Brawley O, Bray F (2012) International variation in prostate cancer incidence and mortality rates. Eur Urol 61(6):1079–1092

    Article  PubMed  Google Scholar 

  2. Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ (2003) Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med 348(17):1625–1638

    Article  PubMed  Google Scholar 

  3. Renehan AG, Tyson M, Egger M, Heller RF, Zwahlen M (2008) Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet 371(9612):569–578

    Article  PubMed  Google Scholar 

  4. Salonia A, Gallina A, Abdollah F, Briganti A, Capitanio U, Suardi N, Ferrari M, Raber M, Colombo R, Freschi M et al (2012) Preoperative circulating sex hormones are not predictors of positive surgical margins at open radical prostatectomy. World J Urol 30(4):533–539

    Article  CAS  PubMed  Google Scholar 

  5. Sher DJ, Mantzoros C, Jacobus S, Regan MM, Lee GS, Oh WK (2009) Absence of relationship between steroid hormone levels and prostate cancer tumor grade. Urology 73(2):356–361 discussion 361–352

    Article  PubMed  Google Scholar 

  6. Schnoeller T, Jentzmik F, Rinnab L, Cronauer MV, Damjanoski I, Zengerling F, Ghazal AA, Schrader M, Schrader AJ (2013) Circulating free testosterone is an independent predictor of advanced disease in patients with clinically localized prostate cancer. World J Urol 31(2):253–259

    Article  CAS  PubMed  Google Scholar 

  7. Machioka K, Mizokami A, Yamaguchi Y, Izumi K, Hayashi S, Namiki M (2015) Active estrogen synthesis and its function in prostate cancer-derived stromal cells. Anticancer Res 35(1):221–227

    CAS  PubMed  Google Scholar 

  8. Carruba G (2006) Estrogens and mechanisms of prostate cancer progression. Ann NY Acad Sci 1089:201–217

    Article  CAS  PubMed  Google Scholar 

  9. Carruba G (2007) Estrogen and prostate cancer: an eclipsed truth in an androgen-dominated scenario. J Cell Biochem 102(4):899–911

    Article  CAS  PubMed  Google Scholar 

  10. Bonkhoff H, Berges R (2009) The evolving role of oestrogens and their receptors in the development and progression of prostate cancer. Eur Urol 55(3):533–542

    Article  CAS  PubMed  Google Scholar 

  11. Cheng J, Lee EJ, Madison LD, Lazennec G (2004) Expression of estrogen receptor beta in prostate carcinoma cells inhibits invasion and proliferation and triggers apoptosis. FEBS Lett 566(1–3):169–172

    Article  PubMed  Google Scholar 

  12. Barrett-Connor E, Garland C, McPhillips JB, Khaw KT, Wingard DL (1990) A prospective, population-based study of androstenedione, estrogens, and prostatic cancer. Cancer Res 50(1):169–173

    CAS  PubMed  Google Scholar 

  13. Salonia A, Gallina A, Briganti A, Suardi N, Capitanio U, Abdollah F, Bertini R, Freschi M, Rigatti P, Montorsi F (2011) Circulating estradiol, but not testosterone, is a significant predictor of high-grade prostate cancer in patients undergoing radical prostatectomy. Cancer 117(22):5029–5038

    Article  CAS  PubMed  Google Scholar 

  14. Epstein JI, Allsbrook WC Jr, Amin MB, Egevad LL (2005) The 2005 international society of urological pathology (ISUP) consensus conference on gleason grading of prostatic carcinoma. Am J Surg Pathol 29(9):1228–1242

    Article  PubMed  Google Scholar 

  15. Vermeulen A, Verdonck L, Kaufman JM (1999) A critical evaluation of simple methods for the estimation of free testosterone in serum. J Clin Endocrinol Metab 84(10):3666–3672

    Article  CAS  PubMed  Google Scholar 

  16. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser 2000, 2000;894:i–xii

  17. Glina S, Rivero MA, Morales A, Morgentaler A (2010) Studies on prostatic cancer I. The effect of castration, of estrogen and of androgen injection on serum phosphatases in metastatic carcinoma of the prostate by Charles Huggins and Clarence V. Hodges. J Sex Med 7(2 Pt 1):640–644

  18. Morgentaler A, Traish AM (2009) Shifting the paradigm of testosterone and prostate cancer: the saturation model and the limits of androgen-dependent growth. Eur Urol 55(2):310–320

    Article  PubMed  Google Scholar 

  19. Van Poppel H, Joniau S (2008) An analysis of radical prostatectomy in advanced stage and high-grade prostate cancer. Eur Urol 53(2):253–259

    Article  PubMed  Google Scholar 

  20. Ellem SJ, Wang H, Poutanen M, Risbridger GP (2009) Increased endogenous estrogen synthesis leads to the sequential induction of prostatic inflammation (prostatitis) and prostatic pre-malignancy. Am J Pathol 175(3):1187–1199

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  21. Leung YK, Lam HM, Wu S, Song D, Levin L, Cheng L, Wu CL, Ho SM (2010) Estrogen receptor beta2 and beta5 are associated with poor prognosis in prostate cancer, and promote cancer cell migration and invasion. Endocr Relat Cancer 17(3):675–689

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  22. Ho CK, Nanda J, Chapman KE, Habib FK (2008) Oestrogen and benign prostatic hyperplasia: effects on stromal cell proliferation and local formation from androgen. J Endocrinol 197(3):483–491

    Article  CAS  PubMed  Google Scholar 

  23. Jentzmik F, Schnoeller TJ, Cronauer MV, Steinestel J, Steffens S, Zengerling F, Al Ghazal A, Schrader MG, Steinestel K, Schrader AJ (2014) Corpulence is the crucial factor: association of testosterone and/or obesity with prostate cancer stage. Int J Urol 21(10):980–986. doi:10.1111/iju.12494

    Article  CAS  PubMed  Google Scholar 

  24. Ellem SJ, Risbridger GP (2010) Aromatase and regulating the estrogen:androgen ratio in the prostate gland. J Steroid Biochem Mol Biol 118(4–5):246–251

    Article  CAS  PubMed  Google Scholar 

  25. Price RS, Cavazos DA, De Angel RE, Hursting SD, deGraffenried LA (2012) Obesity-related systemic factors promote an invasive phenotype in prostate cancer cells. Prostate Cancer Prost Dis 15(2):135–143

    Article  CAS  Google Scholar 

  26. Banez LL, Albisinni S, Freedland SJ, Tubaro A, De Nunzio C (2014) The impact of obesity on the predictive accuracy of PSA in men undergoing prostate biopsy. World J Urol 32(2):323–328

    Article  PubMed  Google Scholar 

  27. Allott EH, Masko EM, Freedland SJ (2013) Obesity and prostate cancer: weighing the evidence. Eur Urol 63(5):800–809

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  28. Osorio CF, de Souza DB, Gallo CB, Costa WS, Sampaio FJ (2014) Leptin and leptin receptor expressions in prostate tumors may predict disease aggressiveness? Acta Cirurgica Brasileira 29(Suppl 3):44–48

    Article  PubMed  Google Scholar 

  29. Noda T, Kikugawa T, Tanji N, Miura N, Asai S, Higashiyama S, Yokoyama M (2015) Long-term exposure to leptin enhances the growth of prostate cancer cells. Int J Oncol 46(4):1535–1542. doi:10.3892/ijo.2015.2845

    PubMed  Google Scholar 

  30. San Francisco IF, Rojas PA, DeWolf WC, Morgentaler A (2014) Low free testosterone levels predict disease reclassification in men with prostate cancer undergoing active surveillance. BJU Int 114(2):229–235

Download references

Conflict of interest

The authors declare there is no conflict of interest.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Author information

Authors and Affiliations

  1. Department of Urology, University of Ulm Medical School, Prittwitzstrasse 43, 89075, Ulm, Germany

    Thomas J. Schnoeller, Friedemann Zengerling & Florian Jentzmik

  2. Department of Urology, University of Münster Medical School, Münster, Germany

    Julie Steinestel & Andres J. Schrader

Authors
  1. Thomas J. Schnoeller
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Julie Steinestel
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Friedemann Zengerling
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Andres J. Schrader
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Florian Jentzmik
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Thomas J. Schnoeller.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Schnoeller, T.J., Steinestel, J., Zengerling, F. et al. Serum 17β-estradiol fails as a marker in identification of aggressive tumour disease in patients with localized prostate cancer. World J Urol 33, 1979–1984 (2015). https://doi.org/10.1007/s00345-015-1567-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-015-1567-7

Keywords

Search

Navigation