Yonsei Med J.  2013 Jul;54(4):902-906. 10.3349/ymj.2013.54.4.902.

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

• Chung MS
• Lee SH
• Lee DH
• Chung BH

• KMID: 2158224
• DOI: http://doi.org/10.3349/ymj.2013.54.4.902

Abstract

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.

Keyword

Prostatic neoplasms; biopsy; prostatectomy

MeSH Terms

Aged
Asian Continental Ancestry Group
Biopsy
Humans
Logistic Models
Male
Middle Aged
Neoplasm Grading
Prostate/pathology/ultrasonography
Prostatectomy/*methods
Prostatic Neoplasms/*pathology/*surgery/ultrasonography
Retrospective Studies

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