Correlation of pretreatment plasma levels of estradiol and sex‐hormone‐binding globulin‐binding capacity with clinical stage and survival of patients with prostatic cancer

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Abstract
Pretreatment plasma concentrations of estradiol‐17β (E2) and the binding capacity of sex‐hormone‐binding globulin (SHBG) were measured in 116 patients with prostatic cancer (PC) categorized into groups according to the UICC classification. By using the SHBG and E2 values, free percentage E2 and free E2 values were calculated. The patients were randomized to orchiectomy or estrogen treatment, and the mean follow‐up time was 42 months. Statistically significant higher (P < .05) pretreatment free E2 and/or E2 values were observed in subjects in which the cancer did not exceed beyond the capsule and was more differentiated and had not metastasized. SHBG values increased significantly (P < .05) with decreasing differentiation. It was observed in addition that survival was statistically significantly longer (P < .05) in subjects with high pretreatment E2 values compared to those with low values when the patients were grouped into three groups according to plasma E2 concentration, ie, 125–175, 75–124, and 20–74 pmol/liter. Survival was particularly poor in the group treated by orchiectomy with the lowest E2 values and statistically significantly different (P < .05) from that of the corresponding group treated by estrogens. However, the overall survival with the two treatments did not differ statistically significantly. Our results support the view that endogenous E2 levels play an inhibitory role in the growth, metastasizing tendency, and differentiation of the tumor and that estrogen treatment may be the treatment of choice for those with low pretreatment E2 levels; for those with medium or high levels orchiectomy seems to be as valuable as estrogen treatment.