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Retzius-Sparing Robot-Assisted Radical Prostatectomy
Published on: May 19, 2022
Prostate volume and pathologic prostate cancer outcomes after radical prostatectomy
Phillip M Pierorazio1, Michael D Kinnaman, Matthew S Wosnitzer
1Department of Urology, Columbia University College of Physicians and Surgeons, New York, New York, USA.
Urology
|November 10, 2007
Summary
Patients with large prostate volumes (PV) are less likely to have aggressive cancer and more likely to have their cancer downgraded. This finding helps in understanding prostate cancer progression and treatment strategies.
Area of Science:
- Urology
- Oncology
- Pathology
Background:
- Prostate volume (PV) is a key factor in prostate cancer assessment.
- Understanding the relationship between PV and cancer characteristics is crucial for accurate diagnosis and treatment planning.
Purpose of the Study:
- To elucidate the relationship between prostate volume (PV) and prostate cancer parameters.
- To investigate the correlation between PV and Gleason sum, extraprostatic extension, and positive margins.
Main Methods:
- Retrospective review of 2600 patients who underwent radical prostatectomy.
- Stratification of patients based on prostate volume: normal (0-40 cm³), moderate (40-80 cm³), and large (>80 cm³).
- Analysis of variance and regression models to assess the impact of PV on cancer variables and Gleason sum discordance.
Main Results:
- Patients with normal PV showed higher rates of Gleason sum > 6 at biopsy and extraprostatic extension.
- Larger PV was associated with a greater likelihood of Gleason sum downgrading between biopsy and pathology.
- Multivariate analysis identified PV, PSA level, and age as predictors of Gleason discordance.
Conclusions:
- Large prostate volume is associated with less aggressive pathologic disease and a higher rate of Gleason sum downgrading.
- Prostate volume is an independent predictor of Gleason discordance.
- These findings aid in refining risk stratification and treatment decisions for prostate cancer patients.