Does larger prostate size provide protection for cancer specific outcomes in localized prostate cancer
Objective Benign prostatic hyperplasia is common in the aging population and frequently comorbid with localized prostate cancer. Large prostate volume places significant challenges in robotic prostatectomy including reduced mobility and visualization. The goal of this study is to evaluate the effect...
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| Veröffentlicht in: | The Prostate 2024-09, Vol.84 (12), p.1098-1103 |
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| creator | Abedali, Zain Woloshuk, Andre Cary, Clint Boris, Ronald S. |
| description | Objective
Benign prostatic hyperplasia is common in the aging population and frequently comorbid with localized prostate cancer. Large prostate volume places significant challenges in robotic prostatectomy including reduced mobility and visualization. The goal of this study is to evaluate the effect of prostate volume as a continuous variable on cancer specific outcomes.
Methods
Three thousand four hundred and twenty five patients with localized prostate cancer at a single institution who underwent robotic prostatectomy were retrospectively reviewed. A number of preoperative, operative, and postoperative variables were collected to evaluate cancer specific outcomes including pathologic stage, tissue margins, and biochemical recurrence (BCR). Logistic regression models and univariate and multivariate analyses were implemented for pathologic stage T3 and BCR respectively.
Results
The median follow up time was 52 months (IQR 18−95). 37.4% of the patients had a final pathologic stage of T3 or higher, 21.2% experienced positive surgical margins, and 24.7% of patients experienced BCR. Prostate size was a significant predictor of all three outcomes of interest. Increasing prostate size was protective against both higher pathologic stage and positive surgical margins (odds ratio = 0.989, 0.990 respectively, p |
| doi_str_mv | 10.1002/pros.24743 |
| format | Article |
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Benign prostatic hyperplasia is common in the aging population and frequently comorbid with localized prostate cancer. Large prostate volume places significant challenges in robotic prostatectomy including reduced mobility and visualization. The goal of this study is to evaluate the effect of prostate volume as a continuous variable on cancer specific outcomes.
Methods
Three thousand four hundred and twenty five patients with localized prostate cancer at a single institution who underwent robotic prostatectomy were retrospectively reviewed. A number of preoperative, operative, and postoperative variables were collected to evaluate cancer specific outcomes including pathologic stage, tissue margins, and biochemical recurrence (BCR). Logistic regression models and univariate and multivariate analyses were implemented for pathologic stage T3 and BCR respectively.
Results
The median follow up time was 52 months (IQR 18−95). 37.4% of the patients had a final pathologic stage of T3 or higher, 21.2% experienced positive surgical margins, and 24.7% of patients experienced BCR. Prostate size was a significant predictor of all three outcomes of interest. Increasing prostate size was protective against both higher pathologic stage and positive surgical margins (odds ratio = 0.989, 0.990 respectively, p < 0.001). There was a modest increase in the risk of BCR with increasing gland size (hazard ratio = 1.006, p < 0.001). These results were most significant for patients with Gleason Grade Groups 1 and 2 prostate cancer.
Conclusion
Prostate size is a commonly determined clinical factor that effects both surgical planning and cancer specific outcomes. Increasing prostate size may offer protection against higher stage disease and positive surgical margins. While surgically challenging, favorable oncologic outcomes can be consistently achieved for patients with low‐intermediate risk disease.</description><identifier>ISSN: 0270-4137</identifier><identifier>ISSN: 1097-0045</identifier><identifier>EISSN: 1097-0045</identifier><identifier>DOI: 10.1002/pros.24743</identifier><identifier>PMID: 38752710</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Hyperplasia ; Population studies ; Prostate cancer ; prostate size ; Prostatectomy ; Regression analysis ; robotic prostatectomy ; Robotic surgery</subject><ispartof>The Prostate, 2024-09, Vol.84 (12), p.1098-1103</ispartof><rights>2024 The Author(s). The Prostate published by Wiley Periodicals LLC.</rights><rights>2024. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3523-48f891cb600c7aa28f43dabdefc12544fc4c49517441e9e6b75f8ff33b1c30353</cites><orcidid>0000-0002-3351-9904</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fpros.24743$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fpros.24743$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38752710$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Abedali, Zain</creatorcontrib><creatorcontrib>Woloshuk, Andre</creatorcontrib><creatorcontrib>Cary, Clint</creatorcontrib><creatorcontrib>Boris, Ronald S.</creatorcontrib><title>Does larger prostate size provide protection for cancer specific outcomes in localized prostate cancer</title><title>The Prostate</title><addtitle>Prostate</addtitle><description>Objective
Benign prostatic hyperplasia is common in the aging population and frequently comorbid with localized prostate cancer. Large prostate volume places significant challenges in robotic prostatectomy including reduced mobility and visualization. The goal of this study is to evaluate the effect of prostate volume as a continuous variable on cancer specific outcomes.
Methods
Three thousand four hundred and twenty five patients with localized prostate cancer at a single institution who underwent robotic prostatectomy were retrospectively reviewed. A number of preoperative, operative, and postoperative variables were collected to evaluate cancer specific outcomes including pathologic stage, tissue margins, and biochemical recurrence (BCR). Logistic regression models and univariate and multivariate analyses were implemented for pathologic stage T3 and BCR respectively.
Results
The median follow up time was 52 months (IQR 18−95). 37.4% of the patients had a final pathologic stage of T3 or higher, 21.2% experienced positive surgical margins, and 24.7% of patients experienced BCR. Prostate size was a significant predictor of all three outcomes of interest. Increasing prostate size was protective against both higher pathologic stage and positive surgical margins (odds ratio = 0.989, 0.990 respectively, p < 0.001). There was a modest increase in the risk of BCR with increasing gland size (hazard ratio = 1.006, p < 0.001). These results were most significant for patients with Gleason Grade Groups 1 and 2 prostate cancer.
Conclusion
Prostate size is a commonly determined clinical factor that effects both surgical planning and cancer specific outcomes. Increasing prostate size may offer protection against higher stage disease and positive surgical margins. While surgically challenging, favorable oncologic outcomes can be consistently achieved for patients with low‐intermediate risk disease.</description><subject>Hyperplasia</subject><subject>Population studies</subject><subject>Prostate cancer</subject><subject>prostate size</subject><subject>Prostatectomy</subject><subject>Regression analysis</subject><subject>robotic prostatectomy</subject><subject>Robotic surgery</subject><issn>0270-4137</issn><issn>1097-0045</issn><issn>1097-0045</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><recordid>eNp90F1LwzAUBuAgipvTG3-AFLwRofOkSZb0UuYnDCZ-XJc0TSSja2bTKvPXm65TwQuvDoEnb3JehI4xjDFAcrGqnR8nlFOyg4YYUh4DULaLhpBwiCkmfIAOvF8ABA7JPhoQwVnCMQyRuXLaR6WsX3UddUGNbHTk7afuTu-22MxGq8a6KjKujpSsVLB-pZU1VkWubZRbhhBbRaVTsgx3i9-onh-iPSNLr4-2c4Rebq6fp3fxbH57P72cxYqwhMRUGJFilU8AFJcyEYaSQuaFNgonjFKjqKIpw5xSrFM9yTkzwhhCcqwIEEZG6KzPDe-_tdo32dJ6pctSVtq1PiPAmEgJYB7o6R-6cG1dhd8FJUJDeEJFUOe9UmEhX2uTrWq7lPU6w5B17Wfdptmm_YBPtpFtvtTFD_2uOwDcgw9b6vU_UdnD4_ypD_0CcmuQoQ</recordid><startdate>202409</startdate><enddate>202409</enddate><creator>Abedali, Zain</creator><creator>Woloshuk, Andre</creator><creator>Cary, Clint</creator><creator>Boris, Ronald S.</creator><general>Wiley Subscription Services, Inc</general><scope>24P</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TO</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3351-9904</orcidid></search><sort><creationdate>202409</creationdate><title>Does larger prostate size provide protection for cancer specific outcomes in localized prostate cancer</title><author>Abedali, Zain ; Woloshuk, Andre ; Cary, Clint ; Boris, Ronald S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3523-48f891cb600c7aa28f43dabdefc12544fc4c49517441e9e6b75f8ff33b1c30353</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Hyperplasia</topic><topic>Population studies</topic><topic>Prostate cancer</topic><topic>prostate size</topic><topic>Prostatectomy</topic><topic>Regression analysis</topic><topic>robotic prostatectomy</topic><topic>Robotic surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Abedali, Zain</creatorcontrib><creatorcontrib>Woloshuk, Andre</creatorcontrib><creatorcontrib>Cary, Clint</creatorcontrib><creatorcontrib>Boris, Ronald S.</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>The Prostate</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Abedali, Zain</au><au>Woloshuk, Andre</au><au>Cary, Clint</au><au>Boris, Ronald S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Does larger prostate size provide protection for cancer specific outcomes in localized prostate cancer</atitle><jtitle>The Prostate</jtitle><addtitle>Prostate</addtitle><date>2024-09</date><risdate>2024</risdate><volume>84</volume><issue>12</issue><spage>1098</spage><epage>1103</epage><pages>1098-1103</pages><issn>0270-4137</issn><issn>1097-0045</issn><eissn>1097-0045</eissn><abstract>Objective
Benign prostatic hyperplasia is common in the aging population and frequently comorbid with localized prostate cancer. Large prostate volume places significant challenges in robotic prostatectomy including reduced mobility and visualization. The goal of this study is to evaluate the effect of prostate volume as a continuous variable on cancer specific outcomes.
Methods
Three thousand four hundred and twenty five patients with localized prostate cancer at a single institution who underwent robotic prostatectomy were retrospectively reviewed. A number of preoperative, operative, and postoperative variables were collected to evaluate cancer specific outcomes including pathologic stage, tissue margins, and biochemical recurrence (BCR). Logistic regression models and univariate and multivariate analyses were implemented for pathologic stage T3 and BCR respectively.
Results
The median follow up time was 52 months (IQR 18−95). 37.4% of the patients had a final pathologic stage of T3 or higher, 21.2% experienced positive surgical margins, and 24.7% of patients experienced BCR. Prostate size was a significant predictor of all three outcomes of interest. Increasing prostate size was protective against both higher pathologic stage and positive surgical margins (odds ratio = 0.989, 0.990 respectively, p < 0.001). There was a modest increase in the risk of BCR with increasing gland size (hazard ratio = 1.006, p < 0.001). These results were most significant for patients with Gleason Grade Groups 1 and 2 prostate cancer.
Conclusion
Prostate size is a commonly determined clinical factor that effects both surgical planning and cancer specific outcomes. Increasing prostate size may offer protection against higher stage disease and positive surgical margins. While surgically challenging, favorable oncologic outcomes can be consistently achieved for patients with low‐intermediate risk disease.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>38752710</pmid><doi>10.1002/pros.24743</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-3351-9904</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | The Prostate, 2024-09, Vol.84 (12), p.1098-1103 |
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| language | eng |
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| source | Wiley Online Library Journals Frontfile Complete |
| subjects | Hyperplasia Population studies Prostate cancer prostate size Prostatectomy Regression analysis robotic prostatectomy Robotic surgery |
| title | Does larger prostate size provide protection for cancer specific outcomes in localized prostate cancer |
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