title: Prostate volume and adverse prostate cancer features: fact not artifact.
abstract: OBJECTIVE
  A recent prostate cancer finasteride chemoprevention trial showed a higher rate of sextant biopsy-detected high grade prostate cancer (HGPCa) in finasteride exposed men, whose prostates were significantly smaller than those of controls. We investigated the association between prostate size and prostate cancer grade and stage in a large (n=3412) single center radical prostatectomy cohort, which was unexposed to any form of hormonal manipulation.
  
  
  METHODS
  Logistic regression models were used.
  
  
  RESULTS
  Small prostates were associated with higher rate of HGPCa at biopsy and at radical prostatectomy (both p<0.001), with higher rate of extracapsular extension (p<0.001), seminal vesicle invasion (p<0.001) and with tumor volume >3.4 cc, after accounting for age, PSA, clinical stage and year of surgery.
  
  
  CONCLUSIONS
  Our findings demonstrate that prostate cancers located in small glands are fundamentally more aggressive than those located within larger glands. In consequence, prostate cancer detection and treatment strategies should account for prostate volume.
authors.affiliation: Cancer Prognostics and Health Outcomes Unit, University of Montreal, Canada.
authors.forename: Alberto
authors.initials: A
authors.lastname: Briganti
authors.forename: Felix K-H
authors.initials: FK
authors.lastname: Chun
authors.forename: Nazareno
authors.initials: N
authors.lastname: Suardi
authors.forename: Andrea
authors.initials: A
authors.lastname: Gallina
authors.forename: Jochen
authors.initials: J
authors.lastname: Walz
authors.forename: Markus
authors.initials: M
authors.lastname: Graefen
authors.forename: Shahrokh
authors.initials: S
authors.lastname: Shariat
authors.forename: Andreas
authors.initials: A
authors.lastname: Ebersdobler
authors.forename: Patrizio
authors.initials: P
authors.lastname: Rigatti
authors.forename: Paul
authors.initials: P
authors.lastname: Perrotte
authors.forename: Fred
authors.initials: F
authors.lastname: Saad
authors.forename: Francesco
authors.initials: F
authors.lastname: Montorsi
authors.forename: Hartwig
authors.initials: H
authors.lastname: Huland
authors.forename: Pierre I
authors.initials: PI
authors.lastname: Karakiewicz
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009929:Organ Size; D011467:Prostate / Q000473:pathology*; D011468:Prostatectomy / Q000379:methods / Q000706:statistics & numerical data*; D011471:Prostatic Neoplasms / Q000473:pathology*; D012044:Regression Analysis; D012669:Seminal Vesicles / Q000473:pathology