Eur Urol. 2008;53:106-111
Low dihydrotestosterone (DHT) may be associated with decreased survival in prostate cancer patients, according to researchers in Sweden.
Anders Kjellman, MD, and colleagues at the Karolinska Insti-tute in Stockholm followed 65 patients with screening-detected prostate cancer for 15 years. The median age at diagnosis was 65 years. A radioimmunoassay was used to measure DHT levels at the time of diagnosis. The researchers followed up patients through Sweden’s nationwide tax register and reviewed medical records of all dead subjects. A committee established the cause of death.
Of the 41 deaths observed, 17 were attributed to prostate cancer. Men with DHT levels above the median had a significantly better prostate-cancer-specific survival than those whose levels were below the median. After adjusting for confounding factors, including PSA level, the association between DHT and prostate-cancer-specific survival was not significant. DHT levels below the median, however, remained significantly associated with decreased survival. The investigators observe no association between DHT levels and the risk of death from causes other than prostate cancer.
“It remains unclear whether DHT at diagnosis has any prognostic value beyond that of PSA and PSA velocity,” the authors wrote, adding that PSA levels merely reflect tumor stage and grade, whereas DHT may play an etiologic role in tumor progression.