Testosterone level does not predict postprostatectomy genomic risk score

No clinical association exists between predefined genomic risk score and testosterone level in men undergoing radical prostatectomy, according to a study.

In this study, the authors explored the correlation between perioperative testosterone level and genomic risk score in patients who underwent radical prostatectomy from 2013 to 2018 and had adverse pathological features in their final surgical specimens (positive margin and/or pT3a or higher).

The primary outcome was the genomic risk score: low (<0.45), intermediate (0.45‒0.6), and high (>0.6), while secondary ones included biochemical recurrence and receipt of secondary treatment. The authors examined the association between serum testosterone and 188 gene expression-based signatures.

Men in the low testosterone group had lower median genomic risk score than those in the intermediate and normal testosterone groups (0.38 vs 0.52 vs 0.53, respectively; p=0.049). Biochemical recurrence-free survival did not differ between the three testosterone groups (p=0.9).

Patients with low testosterone levels were more likely to receive secondary treatment (odds ratio, 2.27, 95 percent confidence interval, 1.14‒4.50; p=0.02) than those with normal levels.

Of the 188 gene expression signatures, 43 were associated with testosterone level (p<0.05). A total of 33 signatures positively correlated with serum testosterone levels, including 12 signatures involved in DNA repair pathways.

“This study adds to the notion of the limited role of endogenous testosterone on the development of de novo high-risk localized prostate cancer,” the authors said.