madman
Super Moderator
Abstract
Introduction: To evaluate the association between preoperative serum prolactin (PRL) levels and risk of non-organ confined prostate cancer (PCa) in clinically localized disease.
Materials and Methods: From December 2007 to December 2011, 124 patients with clinically localized PCa were retrospectively evaluated. Non-organ confined disease in the surgical specimen was defined according to extra-capsular extension, seminal vesicle invasion, positive surgical margins, and lymph node invasion. The association between clinical factors and serum levels of pituitary-testis hormones with the risk of non-organ confined disease was evaluated.
Results: Perioperative factors associated with non-organ confined disease include prostatic-specific antigen (OR 1.144; p = 0.025), proportion of biopsy positive cores (BPC, OR 36.702; p = 0.007), bioptical Gleason Score >6 (OR 2.785; p = 0.034), and PRL (OR 0.756, p < 0.0001). The association was strong for BPC (area under the curve [AUC] 0.704; p < 0.0001) and PRL (AUC 0.299; p < 0.0001). When we dichotomized according to median value, PRL ≤7.7 µg/L was an independent predictor of extraprostatic disease (OR 6.571; p < 0.0001) with fair discrimination power (AUC 0.704; p < 0.0001).
Conclusion: Low preoperative PRL levels predict the risk of non-organ confined PCa in clinically localized disease.
Conclusion
The involvement of PRL, PRL-R, and its mediators in PCa pathogenesis is debated and unclear. This is the only study in the recent literature that provides and supports with new theory the evidence that low preoperative serum PRL levels are associated with non-organ confined PCa. Therefore, the preoperative serum PRL level is a useful tool in planning the patient care strategy, and it should be measured in every patient with PCa. Molecular biology clinical studies are needed to confirm the biological basis of this association and its implications in improvement of therapies of advanced PCa.
