DURHAM, NC — How does the size of prostates affect outcomes from prostate cancer surgery.
A study published in the journal Prostate pointed out that smaller prostates have been linked to unfavorable clinical characteristics and poor short-term outcomes following radical prostatectomy (RP). A study team led by researchers from the Durham, NC, VAMC and Duke University School of Medicine sought to determine the relationship between prostate weight at RP and prostate cancer (PC) outcomes after surgery.1
To do that, researchers focused on 6,242 men in the SEARCH cohort undergoing RP between 1988 and 2017. Defined as the primary outcome was PC-specific mortality (PCSM), while secondary outcomes were biochemical recurrence (BCR), castration-resistant PC (CRPC) and metastasis.
The authors advise that median values for age, pre-RP PSA and prostate weight were 63 years, 6.6 ng/ml, and 42.0 g, respectively. During a median follow-up of 7.9 years, the study reported that 153 (3%) died from PC; 2,103 (34%) had BCR; 203 (3%) developed CRPC; and 289 (5%) developed metastases.
Results indicated that prostate weight was not associated with PCSM in the main analyses (multivariable HR = 1.43; 95% CI: 0.87-2.34) or in sensitivity analyses. Researchers noted that prostate weight was inversely associated with BCR in the main analyses (multivariable HR = 0.70; 95%CI: 0.61-0.79) which was unchanged in sensitivity analyses. Even though hazard ratios for prostate weight and CRPC and metastasis were all elevated, statistical significance was not attained, they explained, with similar results observed in sensitivity analyses.
“Inconsistent results for prostate weight and short-term vs. longer-term outcomes highlight the need to better understand the complex biology leading to prostate size and the relevance of prostate size as a predictor of PC outcomes,” the authors concluded.
- Barlow SK, Oyekunle T, Janes JL, De Hoedt AM, Aronson WJ, Kane CJ, Amling CL, Cooperberg MR, Klaassen ZW, Terris MK, Freedland SJ, Csizmadi I. Prostate weight and prostate cancer outcomes after radical prostatectomy: Results from the SEARCH cohort study. Prostate. 2021 Dec 14. doi: 10.1002/pros.24283. Epub ahead of print. PMID: 34905632.
