Smaller prostate size predicts high grade prostate cancer at final pathology

Mark R. Newton, Sharon Phillips, Sam S. Chang, Peter E. Clark, Michael S. Cookson, Rodney Davis, Jay Fowke, S. Duke Herrell, Roxelyn Baumgartner, Robert Chan, Vineet Mishra, Jeffrey D. Blume, Joseph A. Smith, Daniel A. Barocas

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Purpose: Prostate size may influence the likelihood of detecting high grade prostate cancer at final pathology. We evaluated the association between prostate size and high grade (Gleason score 7 or greater) cancer. Materials and Methods: We analyzed data from 2,880 patients who underwent surgical treatment of prostate cancer between January 2000 and June 2008. Prostate size measured at prostatectomy was compared across a strata of clinical variables (age, body mass index, prostate specific antigen, biopsy Gleason score, clinical stage and year of surgery) and pathological outcomes (final Gleason score, extraprostatic extension, positive surgical margin, seminal vesicle invasion and lymph node involvement). Multivariate logistic regression was used to assess prostate size as a predictor of high grade cancer. Results: Older age, higher prostate specific antigen and later year of surgery were associated with larger gland size. Small prostate size was associated with high grade prostate cancer as well as extraprostatic extension and positive surgical margins on univariate and adjusted analysis. The probability of high grade disease decreased approximately 15% across the lowest vs highest prostate sizes. On multivariate analysis adjusted for age, race, prostate specific antigen, clinical stage, biopsy Gleason score and date of surgery prostate size was an important predictor of high grade disease (OR 0.94; 95% CI 0.92, 0.97 per 2 gm increments, p <0.001). The area under the ROC curve was 0.82 (95% CI 0.81, 0.84). Conclusions: Prostate size was inversely associated with the risk of high grade cancer at final pathology. The ability to predict high grade disease could have implications for the management of prostate cancer.

Original languageEnglish (US)
Pages (from-to)930-937
Number of pages8
JournalJournal of Urology
Volume184
Issue number3
DOIs
StatePublished - Sep 1 2010
Externally publishedYes

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Prostate
Prostatic Neoplasms
Pathology
Neoplasm Grading
Prostate-Specific Antigen
Biopsy
Neoplasms
Seminal Vesicles
Prostatectomy
ROC Curve
Area Under Curve
Body Mass Index
Multivariate Analysis
Logistic Models
Lymph Nodes

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

Newton, M. R., Phillips, S., Chang, S. S., Clark, P. E., Cookson, M. S., Davis, R., ... Barocas, D. A. (2010). Smaller prostate size predicts high grade prostate cancer at final pathology. Journal of Urology, 184(3), 930-937. https://doi.org/10.1016/j.juro.2010.04.082

Smaller prostate size predicts high grade prostate cancer at final pathology. / Newton, Mark R.; Phillips, Sharon; Chang, Sam S.; Clark, Peter E.; Cookson, Michael S.; Davis, Rodney; Fowke, Jay; Herrell, S. Duke; Baumgartner, Roxelyn; Chan, Robert; Mishra, Vineet; Blume, Jeffrey D.; Smith, Joseph A.; Barocas, Daniel A.

In: Journal of Urology, Vol. 184, No. 3, 01.09.2010, p. 930-937.

Research output: Contribution to journalArticle

Newton, MR, Phillips, S, Chang, SS, Clark, PE, Cookson, MS, Davis, R, Fowke, J, Herrell, SD, Baumgartner, R, Chan, R, Mishra, V, Blume, JD, Smith, JA & Barocas, DA 2010, 'Smaller prostate size predicts high grade prostate cancer at final pathology', Journal of Urology, vol. 184, no. 3, pp. 930-937. https://doi.org/10.1016/j.juro.2010.04.082
Newton MR, Phillips S, Chang SS, Clark PE, Cookson MS, Davis R et al. Smaller prostate size predicts high grade prostate cancer at final pathology. Journal of Urology. 2010 Sep 1;184(3):930-937. https://doi.org/10.1016/j.juro.2010.04.082
Newton, Mark R. ; Phillips, Sharon ; Chang, Sam S. ; Clark, Peter E. ; Cookson, Michael S. ; Davis, Rodney ; Fowke, Jay ; Herrell, S. Duke ; Baumgartner, Roxelyn ; Chan, Robert ; Mishra, Vineet ; Blume, Jeffrey D. ; Smith, Joseph A. ; Barocas, Daniel A. / Smaller prostate size predicts high grade prostate cancer at final pathology. In: Journal of Urology. 2010 ; Vol. 184, No. 3. pp. 930-937.
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abstract = "Purpose: Prostate size may influence the likelihood of detecting high grade prostate cancer at final pathology. We evaluated the association between prostate size and high grade (Gleason score 7 or greater) cancer. Materials and Methods: We analyzed data from 2,880 patients who underwent surgical treatment of prostate cancer between January 2000 and June 2008. Prostate size measured at prostatectomy was compared across a strata of clinical variables (age, body mass index, prostate specific antigen, biopsy Gleason score, clinical stage and year of surgery) and pathological outcomes (final Gleason score, extraprostatic extension, positive surgical margin, seminal vesicle invasion and lymph node involvement). Multivariate logistic regression was used to assess prostate size as a predictor of high grade cancer. Results: Older age, higher prostate specific antigen and later year of surgery were associated with larger gland size. Small prostate size was associated with high grade prostate cancer as well as extraprostatic extension and positive surgical margins on univariate and adjusted analysis. The probability of high grade disease decreased approximately 15{\%} across the lowest vs highest prostate sizes. On multivariate analysis adjusted for age, race, prostate specific antigen, clinical stage, biopsy Gleason score and date of surgery prostate size was an important predictor of high grade disease (OR 0.94; 95{\%} CI 0.92, 0.97 per 2 gm increments, p <0.001). The area under the ROC curve was 0.82 (95{\%} CI 0.81, 0.84). Conclusions: Prostate size was inversely associated with the risk of high grade cancer at final pathology. The ability to predict high grade disease could have implications for the management of prostate cancer.",
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AU - Fowke, Jay

AU - Herrell, S. Duke

AU - Baumgartner, Roxelyn

AU - Chan, Robert

AU - Mishra, Vineet

AU - Blume, Jeffrey D.

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AU - Barocas, Daniel A.

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N2 - Purpose: Prostate size may influence the likelihood of detecting high grade prostate cancer at final pathology. We evaluated the association between prostate size and high grade (Gleason score 7 or greater) cancer. Materials and Methods: We analyzed data from 2,880 patients who underwent surgical treatment of prostate cancer between January 2000 and June 2008. Prostate size measured at prostatectomy was compared across a strata of clinical variables (age, body mass index, prostate specific antigen, biopsy Gleason score, clinical stage and year of surgery) and pathological outcomes (final Gleason score, extraprostatic extension, positive surgical margin, seminal vesicle invasion and lymph node involvement). Multivariate logistic regression was used to assess prostate size as a predictor of high grade cancer. Results: Older age, higher prostate specific antigen and later year of surgery were associated with larger gland size. Small prostate size was associated with high grade prostate cancer as well as extraprostatic extension and positive surgical margins on univariate and adjusted analysis. The probability of high grade disease decreased approximately 15% across the lowest vs highest prostate sizes. On multivariate analysis adjusted for age, race, prostate specific antigen, clinical stage, biopsy Gleason score and date of surgery prostate size was an important predictor of high grade disease (OR 0.94; 95% CI 0.92, 0.97 per 2 gm increments, p <0.001). The area under the ROC curve was 0.82 (95% CI 0.81, 0.84). Conclusions: Prostate size was inversely associated with the risk of high grade cancer at final pathology. The ability to predict high grade disease could have implications for the management of prostate cancer.

AB - Purpose: Prostate size may influence the likelihood of detecting high grade prostate cancer at final pathology. We evaluated the association between prostate size and high grade (Gleason score 7 or greater) cancer. Materials and Methods: We analyzed data from 2,880 patients who underwent surgical treatment of prostate cancer between January 2000 and June 2008. Prostate size measured at prostatectomy was compared across a strata of clinical variables (age, body mass index, prostate specific antigen, biopsy Gleason score, clinical stage and year of surgery) and pathological outcomes (final Gleason score, extraprostatic extension, positive surgical margin, seminal vesicle invasion and lymph node involvement). Multivariate logistic regression was used to assess prostate size as a predictor of high grade cancer. Results: Older age, higher prostate specific antigen and later year of surgery were associated with larger gland size. Small prostate size was associated with high grade prostate cancer as well as extraprostatic extension and positive surgical margins on univariate and adjusted analysis. The probability of high grade disease decreased approximately 15% across the lowest vs highest prostate sizes. On multivariate analysis adjusted for age, race, prostate specific antigen, clinical stage, biopsy Gleason score and date of surgery prostate size was an important predictor of high grade disease (OR 0.94; 95% CI 0.92, 0.97 per 2 gm increments, p <0.001). The area under the ROC curve was 0.82 (95% CI 0.81, 0.84). Conclusions: Prostate size was inversely associated with the risk of high grade cancer at final pathology. The ability to predict high grade disease could have implications for the management of prostate cancer.

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