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Related Experiment Videos

Prostate cancer detection: relationship to prostate size.

M E Chen1, P Troncoso, D Johnston

  • 1Department of Urology, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.

Urology
|April 10, 1999
PubMed
Summary

Large prostates have a lower cancer detection rate because they contain more small-volume tumors. Increasing biopsy cores for larger glands may detect more low-progression cancers.

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Area of Science:

  • Urology
  • Oncology
  • Pathology

Background:

  • Prostate cancer detection rates can be lower in larger prostates.
  • This may be due to a smaller proportion of sampled tissue relative to gland size.

Purpose of the Study:

  • To investigate the relationship between prostate gland volume and cancer volume.
  • To simulate prostate biopsies and assess cancer detection likelihood based on gland size and tumor volume.

Main Methods:

  • Whole-mount radical prostatectomy specimens were analyzed.
  • Cancer and gland volumes were determined using planimetry and weighing.
  • Computer simulations of parasagittal sextant biopsies were performed on digitized prostatectomy specimens.

Main Results:

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  • Small-volume cancers (<0.5 cc) were more frequent in larger glands (>50 g).
  • Simulated biopsy detection rates were lower in larger glands (48% vs. 67%).
  • Detection rates for small cancers (<0.5 cc) were significantly lower (18%) compared to larger cancers (>0.5 cc) (73%).

Conclusions:

  • Lower cancer detection in large prostates is linked to a higher prevalence of low-volume tumors.
  • Elevated PSA in large glands may stem from benign tissue, leading to unnecessary biopsies.
  • Increasing biopsy cores based solely on prostate size may overdetect indolent, small-volume cancers.