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Area of Science:

  • Urology
  • Oncology
  • Radiology

Background:

  • Prostate cancer staging and risk stratification are crucial for treatment planning.
  • Prostate volume is a readily available metric from preoperative imaging.

Purpose of the Study:

  • To determine the association between preoperative prostate volume and adverse pathologic features after radical prostatectomy.
  • To assess if clinical stage influences the relationship between prostate volume and adverse pathologic outcomes.

Main Methods:

  • Analysis of 1756 men undergoing preoperative MRI and radical prostatectomy.
  • Logistic regression and Cox proportional hazards models to assess prostate volume's association with pathologic outcomes and recurrence.
  • Interaction analyses to evaluate the effect of clinical stage.

Main Results:

  • Smaller prostate volume correlated with higher Gleason score, extracapsular extension, and positive surgical margins.
  • No significant interaction was found between clinical stage and prostate volume in predicting adverse features.
  • Prostate volume showed a significant association with recurrence in multivariable analysis but not in the preoperative model.

Conclusions:

  • Prostate volume is associated with prostate cancer aggressiveness but does not improve recurrence prediction.
  • The association between prostate volume and aggressiveness is independent of clinical stage.
  • Further prospective research is needed to explore the impact of detection methods on volume-outcome relationships.