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Yu, Lee, Chang, Han, Han, Jeong, Hong, Byun, Choe, and Lee: The Relationship of Prostate Volume and the Grade of Prostate Cancer
Original Article
Korean Journal of Urology

Korean Journal of Urology 2007; 48(10): 1004-1009.

Published online: 31 October 2007

DOI: https://doi.org/10.4111/kju.2007.48.10.1004

The Relationship of Prostate Volume and the Grade of Prostate Cancer

Ji Hyeong Yu, Jeong Woo Lee1, In Ho Chang4, Jun Hyun Han4, Byoung Kyu Han2, Seong-Jin Jeong2, Sung Kyu Hong2, Seok-Soo Byun2, Gheeyoung Choe3, Sang Eun Lee2

Department of Urology, Inje University Sanggye Paik Hospital, Seoul, Korea.

1Department of Urology, Seoul National University Hospital, Korea.

2Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.

3Department of Pathology, Seoul National University Bundang Hospital, Seongnam, Korea.

4KEPCO Medical Foundation Hanil General Hospital, Seoul, Korea.

Corresponding author (selee@snubh.org)

Received 15 January 2007       Accepted 3 September 2007

Copyright © 2007 The Korean Urological Association

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.

Keywords: Prostate, Prostatic neoplasms, Biopsy, Needle

Figures and Tables

Table 1
The characteristics of the patients
kju-48-1004-i001

PSA: prostate-specific antigen, DRE: digital rectal examination TRUS: transrectal ultrasonography

Table 2
Frequency of Gleason scores at biopsy and prostatectomy
kju-48-1004-i002

RRP: radical retropubic prostatectomy

Table 3
Univariate predictors of Gleason pattern 4 or greater cancers at a radical prostatectomy and biopsy
kju-48-1004-i003

PSA: prostate-specific antigen, TRUS: transrectal ultrasonography, DRE: digital rectal examination, RRP: radical retropubic prostatectomy CI: confidence interval, *: p<0.05. Odds ratios (95% CI) are calculated for a 1 year increase in age, a 1ng/ml increase in PSA, a 1cc increase in TRUS volume

Table 4
Multivariate predictors of Gleason pattern 4 or greater cancers at a radical prostatectomy and biopsy
kju-48-1004-i004

PSA: prostate-specific antigen, TRUS: transrectal ultrasonography, DRE: digital rectal examination, RRP: radical retropubic prostatectomy CI: confidence interval., *: p<0.05, †: insignificant values in univariate analysis. Odds ratios (95% CI) are calculated for a 1 year increase in age, a 1ng/ml increase in PSA, a 1cc increase in TRUS volume

Table 5
Gleason score and grade changes over TRUS volume quartiles
kju-48-1004-i005

TRUS: transrectal ultrasonography, No: number, RRP: radical retropubic prostatectomy, *: linear by linear association

Table 6
Comparison of the prevalence rate of high-grade prostate cancer between the lowest quartile and the highest quartile
kju-48-1004-i006

TRUS: transrectal ultrasonography, RRP: radical retropubic prostatectomy

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