Does small prostate predict high grade prostate cancer?

Abstract

Objective: The current is study aimed to assess the patients who underwent radical prostatectomy for prostate cancer and investigate the association between prostate size and adverse outcomes at final pathology. Study Design: Comparative, descriptive study. Place and Duration of Study: Haydarpasa Numune Training and Research Hospital, Turkey, from January 2008 to January 2016. Methodology: The patients treated with open radical prostatectomy for prostate cancer were reviewed. Patient characteristics including prostate specific antigen (PSA), free PSA levels, age, biopsy, and radical prostatectomy results were recorded. The patients whose data were complete or prostate weight was equal to or less than 80 gm, were included in the study. Patients with < 40 gm prostate weight was in group 1 and the patients in group 2 had a prostate weight from 40 to 80 gm. High grade prostate cancer was defined to have a Gleason score between 7 or higher at biopsy and final pathology. Pathology and biopsy results were compared within groups. MedCalc Statistical Software demo version was used for statistical analyses. Results: There were 162 patients in this study. Of these, 71 (43.82%) patients were in group 1 and 91 (56.17%) patients were in group 2. The age ranged from 49 to 76 years. Mean value of 62.70 ±6.82 and 65.82 ±5.66 years in group 1 and 2, respectively. Fifty (70.42%) and 68 patients (74.74%) had a Gleason score of 6 in group 1 and 2, respectively. Organconfined disease was reported in 53 patients (74.64%) in group 1 and in 78 patients (85.71%) in group 2. Gleason score concordance between biopsy and prostatectomy was reported in 61 patients (67.03%) and downgrading was detected in 4 patients (4.4%) in group 2. The median tumor volume of the patients was 4.47 cm3 in group 1 and 6 cm3 in group 2 (p=0.502). High grade prostate cancer was reported in 52.11% and 45.05% of the patients in groups 1 and 2, respectively at final pathology (p=0.373). Conclusion: The present study demonstrated that smaller prostates are more likely to compose higher percentage of the high grade prostate cancer, local advanced disease, and the Gleason upgrading. The positive surgical margin rate is higher in patients with small prostates when it is compared with the other patients.