The prognostic value of serum testosterone to BMI ratio in Chinese males with prostate cancer treated by androgen deprivation therapy: a single-center study

Objective: To investigate the prognostic value of serum testosterone combining with body mass index (BMI) on the prostate cancer (PCa) after androgen deprivation therapy (ADT).

Methods: In this study, we included the patients from June, 2017 to June, 2022 who were diagnosed with PCa and received ADT. The data of these patients were reviewed and analyzed. The ratio of serum testosterone to BMI (T/BMI) was calculated and the patients were divided into high T/BMI and low T/BMI group based on the optimal T/BMI cutoff value.

Results: A total of 84 patients were screened and divided into high T/BMI group (> 0.244) (n = 35) and low T/BMI group (≤ 0.244) (n = 49). Higher possibility of metastasis occurred in low T/BMI than high T/BMI group (P < 0.001) and the PFS in low T/BMI group was significantly lower (P < 0.001) compared to high T/BMI group. Serum testosterone in the high BMI group was significantly lower than that in the non-high BMI group. Testosterone, BMI, and T/BMI were significantly different in the tumor progression group than that in non-tumor progression group (P < 0.05). The result from univariate Cox regression analysis demonstrated that BMI (HR = 1.247, P = 0.001), testosterone (HR = 0.936, P = 0.009), T/BMI(HR = 1.036, P = 0.017), and the metastasis (HR = 1.593, P = 0.025) were significantly correlated with PFS. The result from multivariate Cox regression analysis demonstrated that T/BMI (HR = 1.037, P = 0.015) was significantly correlated with PFS.

Conclusion: T/BMI has a certain predicting value for the prognosis and correlated with PFS of the PCa patients. Higher level of BMI and lower level of testosterone are more associated with poor outcomes than those with low BMI and high testosterone.