title: Prognostic importance of small prostate size in men receiving definitive prostate brachytherapy.
abstract: OBJECTIVE
  To assess whether small prostate size is an adverse prognostic factor in men undergoing brachytherapy in the same manner in which it seems to be for men undergoing radical prostatectomy.
  
  
  METHODS
  From April 1995 to June 2008, 2024 patients underwent brachytherapy by a single brachytherapist. Median follow-up was 7.4 years. The role of small prostate size (≤ 20 cm(3)) as a prognostic factor for biochemical progression-free survival, cause-specific survival, and all-cause mortality was investigated. The differences in survival between men with small and larger prostates were compared using Kaplan-Meier curves and log-rank tests.
  
  
  RESULTS
  Median prostate size for the entire cohort was 32.7 cm(3). For the 167 men with small prostates, median prostate size was 17.4 cm(3). There was no difference in biochemical progression-free survival (95.2% vs 96.2%, P=.603), cause-specific survival (97.7% vs 98.3%, P=.546), or all-cause mortality (78.0% vs 77.2%, P=.838) at 10 years for men with small prostates compared with men with larger prostates. On univariate and multivariate analysis, small prostate size was not associated with any of the primary outcome measures.
  
  
  CONCLUSIONS
  Men with small prostates treated with brachytherapy have excellent outcomes and are at no higher risk of treatment failure than men with larger glands. High-quality implants with adequate margins seem sufficient to address the increased adverse risk factors associated with small prostate size.
authors.affiliation: Western Radiation Oncology, Mountain View, California, USA.
authors.forename: Al V
authors.initials: AV
authors.lastname: Taira
authors.forename: Gregory S
authors.initials: GS
authors.lastname: Merrick
authors.forename: Robert W
authors.initials: RW
authors.lastname: Galbreath
authors.forename: Wayne M
authors.initials: WM
authors.lastname: Butler
authors.forename: Edward
authors.initials: E
authors.lastname: Adamovich
authors.forename: Kent E
authors.initials: KE
authors.lastname: Wallner
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D000726:Androgen Antagonists / Q000627:therapeutic use; D001918:Brachytherapy / Q000379:methods* / Q000401:mortality; D002423:Cause of Death; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D010165:Palladium / Q000627:therapeutic use; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000401:mortality; D011471:Prostatic Neoplasms / Q000097:blood / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy* / Q000628:therapy; D011868:Radioisotopes / Q000627:therapeutic use
chemical_list: D000726:Androgen Antagonists; D007457:Iodine Radioisotopes; D011868:Radioisotopes; D010165:Palladium; D017430:Prostate-Specific Antigen