title: Prostate size and adverse pathologic features in men undergoing radical prostatectomy.
abstract: OBJECTIVE
  To investigate the relationship between prostate volume measured from preoperative imaging and adverse pathologic features at the time of radical prostatectomy and evaluate the potential effect of clinical stage on such relationship.
  
  
  METHODS
  In 1756 men who underwent preoperative magnetic resonance imaging and radical prostatectomy from 2000 to 2010, we examined associations of magnetic resonance imaging-measured prostate volume with pathologic outcomes using univariate logistic regression and with postoperative biochemical recurrence using Cox proportional hazards models. We also analyzed the effects of clinical stage on the relationship between prostate volume and adverse pathologic features via interaction analyses.
  
  
  RESULTS
  In univariate analyses, smaller prostate volume was significantly associated with high pathologic Gleason score (P<.0001), extracapsular extension (P<.0001), and positive surgical margins (P=.032). No significant interaction between clinical stage and prostate volume was observed in predicting adverse pathologic features (all P>.05). The association between prostate volume and recurrence was significant in a multivariable analysis adjusting for postoperative variables (P=.031) but missed statistical significance in the preoperative model (P=.053). Addition of prostate volume did not change C-Indices (0.78 and 0.83) of either model.
  
  
  CONCLUSIONS
  Although prostate size did not enhance the prediction of recurrence, it is associated with aggressiveness of prostate cancer. There is no evidence that this association differs depending on clinical stage. Prospective studies are warranted assessing the effect of initial method of detection on the relationship between volume and outcome.
authors: Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY; Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea. Electronic address: skhong@snubh.org.
authors: Sung Kyu
authors: SK
authors: Hong
authors: Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY.
authors: Bing Ying
authors: BY
authors: Poon
authors: Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY.
authors: Daniel D
authors: DD
authors: Sjoberg
authors: Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY; Department of Urology, Weill Medical College of Cornell University, New York, NY.
authors: Peter T
authors: PT
authors: Scardino
authors: Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY; Department of Urology, Weill Medical College of Cornell University, New York, NY.
authors: James A
authors: JA
authors: Eastham
mesh_terms: D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology*; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery*