Endocrine and metabolic changes in prostate cancer patients after radical prostatectomy

Capa

Citar

Texto integral

Acesso aberto Acesso aberto
Acesso é fechado Acesso está concedido
Acesso é fechado Acesso é pago ou somente para assinantes

Resumo

It has been established that women who undergo hysterectomy, even in cases where the ovaries are preserved, frequently experience premature ovarian insufficiency syndrome, which can lead to various endocrine and metabolic disorders. A comparable inquiry emerges in the context of radical prostatectomy (RP) in males: whether the extraction of the prostate gland itself influences testicular function and the emergence of polymetabolic disorders in the absence of androgen deprivation therapy (ADT).

Radical prostatectomy has been recognized as an effective treatment for localized prostate cancer (PCa), providing high survival rates for patients diagnosed with this disease. The primary focus of specialists in this field has historically centered on the surgical consequences of RP, such as erectile dysfunction and stress urinary incontinence. However, mounting evidence suggests that prostate removal itself can also result in a transient decrease in testosterone levels, manifesting as biochemical or manifest hypogonadism, along with moderate metabolic disturbances, though not to the same extent as observed with adjuvant hormone therapy. In some cases, patients already in the preoperative period may have risk factors for metabolic syndrome, osteopenia, and other perioperative complications, which makes it difficult to objectively assess the direct effect of RP. A more profound comprehension of the pathophysiologic mechanisms underlying these changes appears to be a pivotal element in facilitating timely diagnosis, prevention, and treatment of potential endocrine-metabolic complications associated with RP.

Texto integral

Acesso é fechado

Sobre autores

David Polishchuk

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: polishchukdl@mail.ru
ORCID ID: 0009-0000-7526-4543

Student of the N.V. Sklifosovsky Institute of Clinical Medicine

Rússia, Moscow

Maria Amosova

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Autor responsável pela correspondência
Email: mariaamosova@mail.ru
ORCID ID: 0000-0003-1848-8721

M.D., Ph.D., Associate Professor of the Department of Endocrinology No. 1 of the N.V. Sklifosovsky Institute of Clinical Medicine

Rússia, Moscow

Nikita Amosov

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: nikita_amosov@mail.ru
ORCID ID: 0009-0003-6222-3699

M.D., Ph.D., Senior Researcher of the M.F. Vladimirsky Moscow Regional Clinical Research Institute

Rússia, Moscow

Valentin Fadeev

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: walfad@mail.ru
ORCID ID: 0000-0002-3026-6315

Corr.-Member of the RAS, Dr.Med.Sci., full Prof., Head of the Department of Endocrinology No. 1 of the N.V. Sklifosovsky Institute of Clinical Medicine

Rússia, Moscow

Alexander Amosov

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: Amosov-av@yandex.ru
ORCID ID: 0000-0003-1374-3367

M.D., Dr.Med.Sci., Professor of the Institute of Urology and Human Reproductive Health

Rússia, Moscow

Irina Vasilyeva

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: ivasi55749@gmail.com
ORCID ID: 0000-0001-6925-7048

Ph.D., Associate Professor of the Department of Biological Chemistry of the N.V. Sklifosovsky Institute of Clinical Medicine

Rússia, Moscow

Yuri Demidko

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: demidko1@mail.ru
ORCID ID: 0000-0002-4231-5524

M.D., Dr.Med.Sci., Urologist of Medical and Diagnostic Department No. 4 of the University Clinical Hospital No. 2

Rússia, Moscow

Bibliografia

  1. Cornford P, van den Bergh RCN, Briers E, Van den Broeck T, Brunckhorst O, Darraugh J, Eberli D, De Meerleer G, De Santis M, Farolfi A, Gandaglia G, Gillessen S, Grivas N, Henry AM, Lardas M, van Leenders GJLH, Liew M, Linares Espinos E, Oldenburg J, van Oort IM, Oprea-Lager DE, Ploussard G, Roberts MJ, Rouvière O, Schoots IG, Schouten N, Smith EJ, Stranne J, Wiegel T, Willemse PM, Tilki D. EAU-EANM-ESTRO-ESUR-ISUP-SIOG Guidelines on Prostate Cancer-2024 Update. Part I: Screening, Diagnosis, and Local Treatment with Curative Intent. Eur Urol. 2024 Aug;86(2):148-163. doi: 10.1016/j.eururo.2024.03.027. Epub 2024 Apr 13. PMID: 38614820.
  2. Gacci M, Baldi E, Tamburrino L, Detti B, Livi L, De Nunzio C, Tubaro A, Gravas S, Carini M, Serni S. Quality of Life and Sexual Health in the Aging of PCa Survivors. Int J Endocrinol. 2014;2014:470592. doi: 10.1155/2014/470592. Epub 2014 Mar 17. Erratum in: Int J Endocrinol. 2015;2015:675101. doi: 10.1155/2015/675101. PMID: 24744780; PMCID: PMC3976934.
  3. Kesch C, Heidegger I, Kasivisvanathan V, Kretschmer A, Marra G, Preisser F, Tilki D, Tsaur I, Valerio M, van den Bergh RCN, Fankhauser CD, Zattoni F, Gandaglia G. Radical Prostatectomy: Sequelae in the Course of Time. Front Surg. 2021 May 28;8:684088. doi: 10.3389/fsurg.2021.684088. PMID: 34124138; PMCID: PMC8193923.
  4. Hu JR, Duncan MS, Morgans AK, Brown JD, Meijers WC, Freiberg MS, Salem JE, Beckman JA, Moslehi JJ. Cardiovascular Effects of Androgen Deprivation Therapy in Prostate Cancer: Contemporary Meta-Analyses. Arterioscler Thromb Vasc Biol. 2020 Mar;40(3):e55-e64. doi: 10.1161/ATVBAHA.119.313046. Epub 2020 Jan 23. PMID: 31969015; PMCID: PMC7047549.
  5. Karzai FH, Madan RA, Dahut WL. Metabolic syndrome in prostate cancer: impact on risk and outcomes. Future Oncol. 2016 Aug;12(16):1947-55. doi: 10.2217/fon-2016-0061. Epub 2016 Apr 12. PMID: 27067408; PMCID: PMC5551937.
  6. Mitsuzuka K, Arai Y. Metabolic changes in patients with prostate cancer during androgen deprivation therapy. Int J Urol. 2018 Jan;25(1):45-53. doi: 10.1111/iju.13473. Epub 2017 Oct 20. PMID: 29052905.
  7. Polishchuk D.L., Amosov N.A., Amosova M.V., Fadeev V.V., Amosov A.V. Effect of androgen-deprivation therapy on the endocrine status of patients with prostate cancer. Vopr. urol. androl. (Urology and Andrology). 2024;12(4): 24–29. doi: 10.20953/2307-6631-2024-4-24-29 Russian (Полищук Д.Л., Амосов Н.А., Амосова М.В., Фадеев В.В., Амосов А.В. Влияние андроген-депривационной терапии на эндокринный статус пациентов с раком предстательной железы. Вопросы урологии и андрологии. 2024;12(4): 24–29. doi: 10.20953/2307-6631 2024-4-24-29)
  8. A M El Badri S, Salawu A, Brown JE. Bone Health in Men with Prostate Cancer: Review Article. Curr Osteoporos Rep. 2019 Dec;17(6):527-537. doi: 10.1007/s11914-019-00536-8. PMID: 31760582; PMCID: PMC6944652.
  9. Morote J, Orsola A, Abascal JM, Planas J, Trilla E, Raventos CX, Cecchini L, Encabo G, Reventos J. Bone mineral density changes in patients with prostate cancer during the first 2 years of androgen suppression. J Urol. 2006 May;175(5):1679-83; discussion 1683. doi: 10.1016/S0022-5347(05)00999-7. PMID: 16600728.
  10. Moorman PG, Myers ER, Schildkraut JM, Iversen ES, Wang F, Warren N. Effect of hysterectomy with ovarian preservation on ovarian function. Obstet Gynecol. 2011 Dec;118(6):1271-1279. doi: 10.1097/AOG.0b013e318236fd12. PMID: 22067716; PMCID: PMC3223258.
  11. Podzolkov V.I., Nikitina T.I., Bragina A.E., Podzolkova N.M. Polymetabolic Disorders After Hysterectomy: A Chance Or A Rule? Rational Pharmacotherapy in Cardiology. 2011;7(3):294-299. https://doi.org/10.20996/1819-6446-2011-7-3-294-299 Russian (Подзолков В.И., Никитина Т.И., Брагина А.Е., Подзолкова Н.М. Полиметаболические нарушения после гистерэктомии: случайность или закономерность? Рациональная фармакотерапия в кардиологии. 2011;7(3):294-299. https://doi.org/10.20996/1819-6446-2011-7-3-294-299)
  12. Ahlering TE, My Huynh L, Towe M, See K, Tran J, Osann K, El Khatib FM, Yafi FA. Testosterone replacement therapy reduces biochemical recurrence after radical prostatectomy. BJU Int. 2020 Jul;126(1):91-96. doi: 10.1111/bju.15042. Epub 2020 Apr 1. PMID: 32124531.
  13. Gan S, Liu J, Chen Z, Xiang S, Gu C, Li S, Wang S. Low serum total testosterone level as a predictor of upgrading in low-risk prostate cancer patients after radical prostatectomy: A systematic review and meta-analysis. Investig Clin Urol. 2022 Jul;63(4):407-414. doi: 10.4111/icu.20210459. Epub 2022 May 25. PMID: 35670005; PMCID: PMC9262493.
  14. Huynh LM, Huang E, Towe M, Liang K, El Khatib FM, Yafi FA, Ahlering TE. Evidence for the integration of total and free testosterone levels in the management of prostate cancer. BJU Int. 2022 Jul;130(1):76-83. doi: 10.1111/bju.15626. Epub 2021 Nov 19. PMID: 34716982.
  15. Prostate cancer : [Monograph] / [Kushlinsky N.E., Solovyov Y.N., Trapeznikova M.F., et al.]; Edited by N.E. Kushlinsky [et al.]; Russian Academy of Medical Sciences. – Moscow : Izd-vo RAMS, 2002. – 426, [1] с. : ill., tab., coloured ill. : 31 cm.; ISBN 5-7901-0025-2. Russian (Рак предстательной железы : [Монография] / [Кушлинский Н.Е., Соловьёв Ю.Н., Трапезникова М.Ф. и др.]; Под ред. Н.Е. Кушлинского [и др.]; Рос. акад. мед. наук. — Москва : Изд-во РАМН, 2002. — 426, [1] с. : ил., табл., цв. ил. : 31 см.; ISBN 5-7901-0025-2.)
  16. Dickerman BA, Ahearn TU, Giovannucci E, Stampfer MJ, Nguyen PL, Mucci LA, Wilson KM. Weight change, obesity and risk of prostate cancer progression among men with clinically localized prostate cancer. Int J Cancer. 2017 Sep 1;141(5):933-944. doi: 10.1002/ijc.30803. Epub 2017 Jun 8. PMID: 28543830; PMCID: PMC5518616.
  17. Kim HS, Moreira DM, Smith MR, Presti JC Jr, Aronson WJ, Terris MK, Kane CJ, Amling CL, Freedland SJ. A natural history of weight change in men with prostate cancer on androgen-deprivation therapy (ADT): results from the Shared Equal Access Regional Cancer Hospital (SEARCH) database. BJU Int. 2011 Mar;107(6):924-8. doi: 10.1111/j.1464-410X.2010.09679.x. Epub 2010 Sep 22. PMID: 20860651; PMCID: PMC3055926.
  18. Heracek J, Urban M, Sachova J, Kuncova J, Eis V, Mandys V, Hampl R, Starka L. The endocrine profiles in men with localized and locally advanced prostate cancer treated with radical prostatectomy. Neuro Endocrinol Lett. 2007 Feb;28(1):45-51. PMID: 17277727.
  19. Porcaro AB, Serafin E, Brusa D, Costantino S, Brancelli C, Cerruto MA, Antonelli A. The role of endogenous testosterone in relationship with low- and intermediate-risk prostate cancer: a systematic review. Asian J Androl. 2024 Nov 1;26(6):569-574. doi: 10.4103/aja202443. Epub 2024 Aug 9. PMID: 39119681; PMCID: PMC11614179.
  20. Olsson M, Ekström L, Schulze J, Kjellman A, Akre O, Rane A, Gustafsson O. Radical prostatectomy: influence on serum and urinary androgen levels. Prostate. 2010 Feb 1;70(2):200-5. doi: 10.1002/pros.21053. PMID: 19760638.
  21. Lumbiganon S, Patcharatrakul S, Khongcharoensombat W, Sangkum P. Pre- and post-radical prostatectomy testosterone levels in prostate cancer patients. Int J Impot Res. 2019 Mar;31(2):145-149. doi: 10.1038/s41443-019-0116-0. Epub 2019 Jan 18. PMID: 30659293.
  22. Gacci M, Tosi N, Vittori G, Minervini A, Corona G, Cai T, Morelli AM, Vignozzi L, Serni S, Maggi M, Carini M. Changes in sex hormone levels after radical prostatectomy: Results of a longitudinal cohort study. Oncol Lett. 2013 Aug;6(2):529-533. doi: 10.3892/ol.2013.1420. Epub 2013 Jun 21. PMID: 24137361; PMCID: PMC3789060.
  23. Duarte MF, Luis C, Baylina P, Faria MI, Fernandes R, La Fuente JM. Clinical and metabolic implications of obesity in prostate cancer: is testosterone a missing link? Aging Male. 2019 Dec;22(4):228-240. doi: 10.1080/13685538.2018.1519695. Epub 2018 Oct 24. PMID: 30354924.
  24. Abdollah F, Briganti A, Suardi N, Castiglione F, Gallina A, Capitanio U, Montorsi F. Metabolic syndrome and benign prostatic hyperplasia: evidence of a potential relationship, hypothesized etiology, and prevention. Korean J Urol. 2011 Aug;52(8):507-16. doi: 10.4111/kju.2011.52.8.507. Epub 2011 Aug 22. PMID: 21927696; PMCID: PMC3162215.
  25. Rył A, Rotter I, Miazgowski T, Słojewski M, Dołęgowska B, Lubkowska A, Laszczyńska M. Metabolic syndrome and benign prostatic hyperplasia: association or coincidence? Diabetol Metab Syndr. 2015 Oct 29;7:94. doi: 10.1186/s13098-015-0089-1. PMID: 26516352; PMCID: PMC4625953.
  26. Kelkar S, Oyekunle T, Eisenberg A, Howard L, Aronson WJ, Kane CJ, Amling CL, Cooperberg MR, Klaassen Z, Terris MK, Freedland SJ, Csizmadi I. Diabetes and Prostate Cancer Outcomes in Obese and Nonobese Men After Radical Prostatectomy. JNCI Cancer Spectr. 2021 Mar 9;5(3):pkab023. doi: 10.1093/jncics/pkab023. PMID: 34169227; PMCID: PMC8220304.
  27. Liu Z, Zhu X, He J, Lu J. Metabolic syndrome and its components predict the biochemical recurrence and adverse pathological features of patients following radical prostatectomy: a propensity score matching study. BMC Cancer. 2023 Jan 14;23(1):50. doi: 10.1186/s12885-023-10507-z. PMID: 36641426; PMCID: PMC9840841.
  28. Miller LR, Partin AW, Chan DW, Bruzek DJ, Dobs AS, Epstein JI, Walsh PC. Influence of radical prostatectomy on serum hormone levels. J Urol. 1998 Aug;160(2):449-53. PMID: 9679896.
  29. Teishima J, Inoue S, Hayashi T, Matsubara A. Change of preoperative symptoms of the late-onset hypogonadism syndrome after robot-assisted radical prostatectomy. Curr Urol. 2021 Jun;15(2):85-90. doi: 10.1097/CU9.0000000000000020. Epub 2021 May 24. PMID: 34168525; PMCID: PMC8221015.
  30. Chen Z, Deng J, Yan Y, Li M, Chen C, Chen C, Zhao S, Song T, Liu T, Wen X, Yao Y. Risk Analysis of Prostate Cancer Treatments in Promoting Metabolic Syndrome Development and the Influence of Increased Metabolic Syndrome on Prostate Cancer Therapeutic Outcome. Horm Cancer. 2018 Aug;9(4):278-287. doi: 10.1007/s12672-018-0335-8. Epub 2018 Jun 9. PMID: 29948970; PMCID: PMC6061238.
  31. Zheng X, Han X, s H, Ai J, Yang L, Wei Q. Prognostic value of lipid profiles after radical prostatectomy: a systematic review and meta-analysis. Lipids Health Dis. 2019 May 28;18(1):124. doi: 10.1186/s12944-019-1068-6. PMID: 31138210; PMCID: PMC6540553.
  32. Kim DK, Lee JY, Kim KJ, Hong N, Kim JW, Hah YS, Koo KC, Kim JH, Cho KS. Effect of Androgen-Deprivation Therapy on Bone Mineral Density in Patients with Prostate Cancer: A Systematic Review and Meta-Analysis. J Clin Med. 2019 Jan 18;8(1):113. doi: 10.3390/jcm8010113. PMID: 30669289; PMCID: PMC6352073.
  33. Torres LO. Do we have enough evidences that make you safe to treat a man with hypogonadism one year after a radical prostatectomy for prostate cancer? | Opinion: YES. Int Braz J Urol. 2018 Jan-Feb;44(1):4-7. doi: 10.1590/S1677-5538.IBJU.2018.0003. PMID: 29424506; PMCID: PMC5815526.
  34. Valderrábano RJ, Pencina K, Storer TW, Reid KF, Kibel AS, Burnett AL, Huang G, Dorff T, Privat F, Ghattas-Puylara C, Wilson L, Latham NK, Holmberg M, Bhasin S. Testosterone replacement in prostate cancer survivors with testosterone deficiency: Study protocol of a randomized controlled trial. Andrology. 2023 Jan;11(1):93-102. doi: 10.1111/andr.13299. Epub 2022 Oct 13. PMID: 36181480; PMCID: PMC9771994.

Arquivos suplementares

Arquivos suplementares
Ação
1. JATS XML
Baixar

Declaração de direitos autorais © Bionika Media, 2025