World Journal of Urology

, Volume 31, Issue 2, pp 275–280 | Cite as

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

  • Andrea Salonia
  • Firas Abdollah
  • Umberto Capitanio
  • Andrea Gallina
  • Nazareno Suardi
  • Alberto Briganti
  • Giuseppe Zanni
  • Matteo Ferrari
  • Fabio Castiglione
  • Maria Chiara Clementi
  • Patrizio Rigatti
  • Francesco Montorsi
Original Article



We sought the association of preoperative serum total testosterone (tT), hypogonadism, 17β estradiol (E2), 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, E2, and SHBG] and early BCR (defined as a PSA ≥ 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, E2, and SHBG levels, rate of hypogonadism, and clinical stage as compared with those without BCR (all p ≥ 0.05). Conversely, patients with BCR showed a greater prevalence of biopsy Gleason scores ≥4 + 3 (all p ≤ 0.001). At multivariable Cox regression analysis, tT [hazard ratio (HR): 1.43; p = 0.03] E2 (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 ≥8 (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.


Prostate cancer Radical prostatectomy Biochemical recurrence Testosterone 17β Estradiol Sex hormone-binding globulin 



The authors thank Dragonfly Editorial for reviewing the language in this manuscript.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Andrea Salonia
    • 1
  • Firas Abdollah
    • 1
  • Umberto Capitanio
    • 1
  • Andrea Gallina
    • 1
  • Nazareno Suardi
    • 1
  • Alberto Briganti
    • 1
  • Giuseppe Zanni
    • 1
  • Matteo Ferrari
    • 1
  • Fabio Castiglione
    • 1
  • Maria Chiara Clementi
    • 1
  • Patrizio Rigatti
    • 1
  • Francesco Montorsi
    • 1
  1. 1.Department of UrologyUniversity Vita-Salute San RaffaeleMilanItaly

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