Korean J Urol.  2007 Oct;48(10):1004-1009. 10.4111/kju.2007.48.10.1004.

The Relationship of Prostate Volume and the Grade of Prostate Cancer

• Yu JH
• Lee JW
• Chang IH
• Han JH
• Han BK
• Jeong SJ
• Hong SK
• Byun SS
• Choe G
• Lee SE

• KMID: 2139730
• DOI: http://doi.org/10.4111/kju.2007.48.10.1004

Abstract

PURPOSE: A prostate cancer prevention trial has demonstrated a higher incidence of high-grade prostate cancers(HGPC, Gleason pattern 4 or greater) among men randomized to receive treatment with finasteride. One of the hypotheses was finasteride causes a detection bias with regards to HGPC by reducing the prostate volume. We investigated the relationship between prostate volume and HGPC in prostate biopsy specimens and prostatectomy specimens(RP) from the same patients.
MATERIALS AND METHODS
We retrospectively reviewed a cohort of 173 consecutive patients that underwent a radical prostatectomy. We identified risk factors for HGPC on 12 core needle biopsies and then on RP specimens using univariate and multivariate logistic regression analysis. In transrectal ultrasound(TRUS) volume quartiles, the relationship of HGPC and prostate volume was analyzed between the lowest and the highest quartile.
RESULTS
By multivariate analysis, risk factors of HGPC were age and prostate-specific antigen(PSA), but TRUS volume was not associated with HGPC in both biopsy and RP specimens. In TRUS volume quartiles, the relationship of HGPC and prostate volume was not significant. In addition, in a comparison of the lowest and the highest quartile, the relationship of HGPC and prostate volume was not significant.
CONCLUSIONS
Prostate volume may not be significantly associated with the grade of prostate cancers diagnosed at 12 core(or more) needle biopsies and at a radical prostatectomy.

Keyword

Prostate; Prostatic neoplasms; Biopsy; Needle

MeSH Terms

Bias (Epidemiology)
Biopsy
Biopsy, Large-Core Needle
Biopsy, Needle
Cohort Studies
Finasteride
Humans
Incidence
Logistic Models
Male
Multivariate Analysis
Needles
Prostate*
Prostatectomy
Prostatic Neoplasms*
Retrospective Studies
Risk Factors
Finasteride

Reference

1. Neill MG, Fleshner NE. An update on chemoprevention strategies in prostate cancer for 2006. Curr Opin Urol. 2006. 16:132–137.

2. Thompson IM, Goodman PJ, Tangen CM, Lucia MS, Miller GJ, Ford LG, et al. The influence of finasteride on the development of prostate cancer. N Engl J Med. 2003. 349:215–224.

3. Scardino PT. The prevention of prostate cancer-the dilemma continues. N Engl J Med. 2003. 349:297–299.

4. Mellon JK. The finasteride prostate cancer prevention trial (PCPT)-what have we learned? Eur J Cancer. 2005. 41:2016–2022.

5. Thompson IM, Klein EA, Lippman SM, Coltman CA, Djavan B. Prevention of prostate cancer with finasteride: US/European perspective. Eur Urol. 2003. 44:650–655.

6. Naughton CK, Miller DC, Mager DE, Ornstein DK, Catalona WJ. A prospective randomized trial comparing 6 versus 12 prostate biopsy cores: impact on cancer detection. J Urol. 2000. 164:388–392.

7. Bae KS, Chang SG. Comparative analysis between sextant biopsy and 12-samples needle biopsy for detection of stage T1c prostate cancer. Korean J Urol. 2004. 45:653–657.

8. Chen ME, Troncoso P, Johnston D, Tang K, Babaian RJ. Prostate cancer detection: relationship to prostate size. Urology. 1999. 53:764–768.

9. Park HK, Byun SS, Sohn DW, Hong SK, Lee E, Lee SE, et al. The efficacy of 12-site biopsy protocol in men with elevated serum prostate-specific antigen level only. Korean J Urol. 2005. 46:463–466.

10. San Francisco IF, DeWolf WC, Rosen S, Upton M, Olumi AF. Extended prostate needle biopsy improves concordance of Gleason grading between prostate needle biopsy and radical prostatectomy. J Urol. 2003. 169:136–140.

11. Eskicorapci SY, Guliyev F, Akdogan B, Dogan HS, Ergen A, Ozen H. Individualization of the biopsy protocol according to the prostate gland volume for prostate cancer detection. J Urol. 2005. 173:1536–1540.

12. Kulkarni GS, Al-Azab R, Lockwood G, Toi A, Evans A, Trachtenberg J, et al. Evidence for a biopsy derived grade artifact among larger prostate glands. J Urol. 2006. 175:505–509.

13. Karakiewicz PI, Bazinet M, Aprikian AG, Trudel C, Aronson S, Nachabe M, et al. Outcome of sextant biopsy according to gland volume. Urology. 1997. 49:55–59.

14. Basillote JB, Armenakas NA, Hochberg DA, Fracchia JA. Influence of prostate volume in the detection of prostate cancer. Urology. 2003. 61:167–171.

15. Freedland SJ, Isaacs WB, Platz EA, Terris MK, Aronson WJ, Amling CL, et al. Prostate size and risk of high-grade, advanced prostate cancer and biochemical progression after radical prostatectomy: a search database study. J Clin Oncol. 2005. 23:7546–7554.

16. D'Amico AV, Renshaw AA, Arsenault L, Schultz D, Richie JP. Clinical predictors of upgrading to Gleason grade 4 or 5 disease at radical prostatectomy: potential implications for patient selection for radiation and androgen suppression therapy. Int J Radiat Oncol Biol Phys. 1999. 45:841–846.

17. Fukagai T, Namiki T, Namiki H, Carlile RG, Shimada M, Yoshida H. Discrepancies between Gleason scores of needle biopsy and radical prostatectomy specimens. Pathol Int. 2001. 51:364–370.