Pretreatment plasma testosterone and estradiol levels in patients with locally advanced or metastasized prostatic cancer

BACKGROUND. Studies concerning pretreatment plasma hormonal environment in relation to stage of prostatic cancer have given conflicting results. The a im of the present study was to compare the pretreatment plasma testosterone (T), free T (fT), estradiol (E2), and free E2 (fE2) levels in patients wit h locally advanced (T3-4 MO) and metastatic (T1-4 M1) prostatic cancer, and to further examine the effect of the patients' general condition on these levels. METHODS. The present series consisted of 238 patients (Finnprostate 6 study ). The variables analyzed were E2, fE2, T, fT, age, body mass index(BMI), s ex hormone binding globulin capacity (SHBG), prostate-specific antigen (PSA ), alkaline phosphatase (ALP), hemoglobin concentration (Hb), erythrocyte s edimentation rate (ESR), and performance status (PS). RESULTS. The E2 and fE2 levels were significantly higher in MO patients tha n in M1 patients, with no significant differences in T and fT levels. In mu ltivariate analyses, a decline in performance status (PS), an increase in E SR, or a decrease in Hb, were related to a decrease in T, fT, E2, or fE2 le vels. CONCLUSIONS. Pretreatment plasma estradiol was significantly lower in M1 pa tients than in MO patients, but there were ncs significant differences in T levels, although the poor general condition was related to a decrease in t he pretreatment levels of both testosterone and estradiol. (C) 1999 Wiley-L iss, Inc.