Low Testosterone May Signal Need for PCa Reclassification

Men under active surveillance for prostate cancer who have reductions in testosterone levels may be at increased risk for disease reclassification, according to research published in BJU International.

Ignacio F. San Francisco, M.D., of the Pontificia Universidad Catolica de Chile, Santiago, and colleagues analyzed data from a cohort of 154 men on active surveillance for prostate cancer to assess the association between testosterone levels and risk of disease reclassification.

The researchers found that patients who had disease that was reclassified, compared with those who did not, had significantly lower levels of free testosterone (0.75 versus 1.02 ng/dL; P=0.03). A higher rate of reclassification of disease was observed in patients with free testosterone levels <0.45 ng/dL than in those with levels ≥0.45 ng/dL (P=0.032).

Patients with free testosterone levels <0.45 ng/dL were at increased risk of disease reclassification (odds ratio, 4.3; 95 percent confidence interval, 1.25 to 14.73). Independent predictors of disease reclassification included free testosterone level and family history of prostate cancer.

"Men with moderately severe reductions in free testosterone level are at increased risk of disease reclassification," the authors write.

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