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Preoperative Serum Sex Hormone-Binding Globulin Level is an Independent Predictor of Biochemical Outcome After Radical Prostatectomy : 근치적 전립선적출술 전 혈중 성호르몬결합글로불린 농도가 수술 후 생화학적 재발에 미치는 영향
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- Authors
- Advisor
- 홍성규
- Major
- 의과대학 의학과
- Issue Date
- 2016-02
- Publisher
- 서울대학교 대학원
- Keywords
- 전립선암 ; 성호르몬결합글로불린 ; 근치적 전립선적출술
- Description
- 학위논문 (석사)-- 서울대학교 대학원 : 의학과 비뇨기과학 전공, 2016. 2. 홍성규.
- Abstract
- Objective: To investigate the significance of preoperative serum sex hormone-binding globulin (SHBG) level regarding the postoperative biochemical outcome in patients who were followed up for relative longer periods after undergoing radical prostatectomy (RP).
Patients and Methods: Preoperative serum levels of testosterone (T), free T, and SHBG level were prospectively analyzed in 307 consecutive patients who underwent RP at our institution between January 2006 and July 2007. We analyzed potential associations of sex hormones with postoperative biochemical recurrence (BCR)-free survival via multivariate Cox proportional regression analysis.
Results: Mean postoperative follow-up duration for 307 total patients was 72.1±19.6 months. Kaplan-Meier curve demonstrated that BCR-free survival was significantly worse in patients with higher (≥ 40 ng/ml) SHBG level than others (P < 0.001). Serum T (P = 0.280) and free T (P = 0.606) levels showed no significant association with biochemical outcome. In multivariate analysis encompassing postoperative variables along with PSA, T, and free T, SHBG level (HR 1.825, 1.061-3.138
P = 0.030) was observed to be independently associated with BCR-free survival. Addition of SHBG level to the multivariate model for prediction of BCR-free survival resulted in increased accuracy (83.5% vs 82.2%
P = 0.164).
Conclusion: Our study of patients who were followed up for relative longer periods after RP shows that preoperative serum SHBG level, but not T, is an independent predictor of postoperative BCR-free survival. According to our findings, SHBG measurement may be useful in the selection of candidates for adjuvant treatment following RP.
- Language
- English
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