BACKGROUND: We investigated the association of 5α-reductase inhibitor (5-ARI) treatment with pathologic and biochemical outcome among the contemporary prostate cancer (PCa) patients undergoing radical prostatectomy. METHODS: We reviewed records of 1,204 men who underwent radical prostatectomy from 2003 to 2010. We estimated association of 5-ARI use with high (≥7) pathologic Gleason score and pathologically nonorgan-confined disease (≥pT3) via logistic regression, and biochemical outcome via Cox proportional hazards regression. RESULTS: Of 1,204 patients, 50 (4.2%) reported having history 5-ARI treatment before radical prostatectomy. Median duration of 5-ARI treatment among the 50 patients was 23.0 months. When adjusted for various factors including age, body mass index, prostate-specific antigen, clinical stage, biopsy Gleason, and prostate volume, history of 5-ARI treatment was revealed to be significantly associated with high (≥7) pathologic Gleason score (P = 0.015). Also, 5-ARI use was observed to significantly associated with higher rates of extraprostatic extension of tumor (P = 0.005) and seminal vesicle invasion (P = 0.003), respectively, when adjusted for same variables. However, 5-ARI use was not demonstrated to be a significant preoperative predictor of biochemical recurrence-free survival in multivariate analysis (P = 0.528). CONCLUSIONS: Our results showed 5-ARI treatment may be associated with more aggressive PCa demonstrating higher pathologic Gleason score and advanced pathologic tumor stage in men undergoing radical prostatectomy. However, further investigations via larger-scale, prospective studies would be needed on the actual effect of 5-ARI treatment on PCa-specific morbidity and mortality.
BACKGROUND: We investigated the association of 5α-reductase inhibitor (5-ARI) treatment with pathologic and biochemical outcome among the contemporary prostate cancer (PCa) patients undergoing radical prostatectomy. METHODS: We reviewed records of 1,204 men who underwent radical prostatectomy from 2003 to 2010. We estimated association of 5-ARI use with high (≥7) pathologic Gleason score and pathologically nonorgan-confined disease (≥pT3) via logistic regression, and biochemical outcome via Cox proportional hazards regression. RESULTS: Of 1,204 patients, 50 (4.2%) reported having history 5-ARI treatment before radical prostatectomy. Median duration of 5-ARI treatment among the 50 patients was 23.0 months. When adjusted for various factors including age, body mass index, prostate-specific antigen, clinical stage, biopsy Gleason, and prostate volume, history of 5-ARI treatment was revealed to be significantly associated with high (≥7) pathologic Gleason score (P = 0.015). Also, 5-ARI use was observed to significantly associated with higher rates of extraprostatic extension of tumor (P = 0.005) and seminal vesicle invasion (P = 0.003), respectively, when adjusted for same variables. However, 5-ARI use was not demonstrated to be a significant preoperative predictor of biochemical recurrence-free survival in multivariate analysis (P = 0.528). CONCLUSIONS: Our results showed 5-ARI treatment may be associated with more aggressive PCa demonstrating higher pathologic Gleason score and advanced pathologic tumor stage in men undergoing radical prostatectomy. However, further investigations via larger-scale, prospective studies would be needed on the actual effect of 5-ARI treatment on PCa-specific morbidity and mortality.