Scandinavian Journal of Urology and Nephrology

ISSN: 0036-5599 (Print) 1651-2065 (Online) Journal homepage: http://www.tandfonline.com/loi/isju19

Effect of Orchidectomy on Serum Concentrations of Testosterone and Dihydrotestosterone in Patients with Prostatic Cancer Hardy F. Røhl & Hans-Peter Beuke To cite this article: Hardy F. Røhl & Hans-Peter Beuke (1992) Effect of Orchidectomy on Serum Concentrations of Testosterone and Dihydrotestosterone in Patients with Prostatic Cancer, Scandinavian Journal of Urology and Nephrology, 26:1, 11-14 To link to this article: http://dx.doi.org/10.3109/00365599209180389

Published online: 15 Feb 2010.

Submit your article to this journal

Article views: 9

View related articles

Citing articles: 4 View citing articles

Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=isju19 Download by: [Deakin University Library]

Date: 05 November 2015, At: 22:12

Scand J Urol Nephrol 26: 11-14, 1992

EFFECT OF ORCHIDECTOMY ON SERUM CONCENTRATIONS OF TESTOSTERONE AND DIHYDROTESTOSTERONE IN PATIENTS WITH PROSTATIC CANCER Hardy F. Rerhl a n d Hans-Peter Beuke Froin tire Dc>purtmciit of Lbdo~qy.Odcmsc C'niLvrsiry Hospirul. Deninark

Downloaded by [Deakin University Library] at 22:12 05 November 2015

(Submitted May 16. 1990. Accepted for publication December 17. 1990)

.-lhJtruct. Because it is well known that prostatic cancer is dependent o n testosterone, and that dihydrotestosterone is the active mediator of the androgen action in the prostatic cell, we studied serum concentrations of testosterone and dihydrotestosterone in 84 patients with prostatic cancer. 40 of whom were treated by orchidectomy. and 44 who were not treated. There was a significant correlation between testosterone and di h yd rotestosterone concentrations in the untreated group, but no correlation among the patients treated by orchidectomy. T h e results indicate that the effectiveness of orchidectomy as androgen withdrawal treatment in prostatic cancer should be assessed by measurement of both dihydrotestosterone and testosterone concentrations.

Kev iiwd.s; prostatic cancer, testosterone, dihydrotestosterone. orchidectomy.

Huggins et al. (6) werc the first to report that prostatic cancer is androgen dependent. Testosterone (TT). mainly of testicular origin, is the principal circulating androgen, but it is the active 5 a-reduced metabolite, dihydrotestosterone ( D H T ) , that is essential for cellular growth and function of the prostatic tissue ( I 1). To control the effectiveness of androgen ablative treatment for prostatic cancer. we use the serum concentration of TT as a measure of the degree of suppression of the androgen dcpendent tumour cells. T h e object of this study was t o find out if a balanced relationship exists between TT a n d D H T serum concentration in patients with prostatic cancer, and whether hormone ablative treatment by orchidectomy has any effect on these two hormones.

tients (mean age 72 years, range 56-83) with T3, M , N , tumours together with pain were treated by orchidectomy. Forty-four patients (mean age 72 years, range 57-84) with T,,~, M, N , tumours but no pain were not treated. Total serum concentrations of TT and D H T were measured in all patients before any decision about treatment was made. After orchidectomy. the patients were monitored by measurement of TT a n d D H T concentrations at intervals of I . 3. 6. and 12 months and we collected blood samples from 40. 36. 23. and 14 patients, respectively. None of the patients was treated with steroids. oestrogens. or anti-androgens. Serum TT and D H T concentrations were measured in blood samples that were collected between 09.00 and 12.00 by a standardised routine: any circadian variation or other disturbances were therefore niinimised. T h e hormones were analysed as unconjugated steroids in the serum (free and protein-bound fractions) by multiple steroid radioimmunoassay. preceding ether extraction and chromatography. modified from that described by Parker et al. (9). This assay is a routine method for measuring hormone concentrations in patients with disorders of sex differentiation. The precision of steroid concentrations (coefficient of variation) determined by the method. which has high sensitivity for the measurement of steroids in a small sample of plasma (varying between 48 and 5 5 nmol/l for TT and DHT. respectively). has been reported t o be 5-6% (9). The specificity was achieved by highly specific antisera with an immunological cross-reactivity of i 0 . 5 941 with steroids other than TT and D H T (9. 10). The significance of differences between serum TT and DHT values was assessed by Spearman's rank correlation coefficient. Student's f-test. and the Jonckheere-Terpstra test for trend. Probabilities of lcss than 0.05 were accepted as significant.

K ESULTS

PATIENTS A N D M E T H O D S Eighty-four patients with histologically confirmed but untreated prostatic cancer were evaluated. Forty pa-

T h e relation of serum TT t o D H T concentrations for untreated prostatic cancer is shown in Fig. 1 . and that aftcr hormone ablative treatS a n d J l t o l N2phrol 26

12

H . F. R0hl and H.-P. Belike and 12 months, respectively, showing no correlation between serum T T and DHT concentrations.

OHT lnrnolll)

81 5 i 4 1

DISCUSSION

0

5

10

15

20

25

30

35

40

45

50

Ti (nmolfl)

Downloaded by [Deakin University Library] at 22:12 05 November 2015

Fig I. The correlation between serum testosterone (TT) and dihydrotestosterone (DHT) concentrations in patients with untreated prostatic cancer (n=84; R=0.8084, p>O.001).

ment in Fig. 2. Table I shows the median value and the 95% confidence intervals (CI) of the medians of serum T T and DHT, and the median D H T : T T ratio before and I , 3, 6, and 12 months after treatment. The DHT : T T ratio increased significantly with time after orchidectomy (Jonckheere-Terpstra test, J* = 1.97, p

Effect of orchidectomy on serum concentrations of testosterone and dihydrotestosterone in patients with prostatic cancer.

Because it is well known that prostatic cancer is dependent on testosterone, and that dihydrotestosterone is the active mediator of the androgen actio...
502KB Sizes 0 Downloads 0 Views