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Is Small Prostate Volume a Predictor of Gleason Score Upgrading after Radical Prostatectomy?

 Mun Su Chung  ;  Seung Hwan Lee  ;  Dong Hoon Lee  ;  Byung Ha Chung 
 YONSEI MEDICAL JOURNAL, Vol.54(4) : 902-906, 2013 
Journal Title
Issue Date
Aged ; Asian Continental Ancestry Group ; Biopsy ; Humans ; Logistic Models ; Male ; Middle Aged ; Neoplasm Grading ; Prostate/diagnostic imaging ; Prostate/pathology ; Prostatectomy/methods* ; Prostatic Neoplasms/diagnostic imaging ; Prostatic Neoplasms/pathology* ; Prostatic Neoplasms/surgery* ; Retrospective Studies ; Ultrasonography
Prostatic neoplasms ; biopsy ; prostatectomy
PURPOSE: We aimed to analyze the relationship between prostate volume and Gleason score (GS) upgrading [higher GS category in the radical prostatectomy (RP) specimen than in the prostate biopsy] in Korean men. MATERIALS AND METHODS: We retrospectively analyzed the medical records of 247 men who underwent RP between May 2006 and April 2011 at our institution. Transrectal ultrasound (TRUS) volume was categorized as 25 cm³ or less (n=61), 25 to 40 cm³ (n=121) and greater than 40 cm³ (n=65). GS was examined as a categorical variable of 6 or less, 3+4 and 4+3 or greater. The relationship between TRUS volume and upgrading of GS was analyzed using multivariate logistic regression. RESULTS: Overall, 87 patients (35.2%) were upgraded, 20 (8.1%) were downgraded, and 140 (56.7%) had identical biopsy and pathological Gleason sum groups. Smaller TRUS volume was significantly associated with increased likelihood of upgrading (p trend=0.022). Men with prostates 25 cm³ or less had more than 2.7 times the risk of disease being upgraded relative to men with TRUS volumes more than 40 cm³ (OR 2.718, 95% CI 1.403-8.126). CONCLUSION: In our study, smaller prostate volumes were at increased risk for GS upgrading after RP. This finding should be kept in mind when making treatment decisions for men with prostate cancer that appears to be of a low grade on biopsy, especially in Asian urologic fields.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Lee, Dong Hoon(이동훈)
Lee, Seung Hwan(이승환) ORCID logo https://orcid.org/0000-0001-7358-8544
Chung, Byung Ha(정병하) ORCID logo https://orcid.org/0000-0001-9817-3660
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