title: Prostate volume predicts high grade prostate cancer both in digital rectal examination negative (ct1c) and positive (≥ct2) patients.
abstract: BACKGROUND
  We aimed to assess the relationship between prostate volume (PV) and high grade prostate carcinoma (HGPCa) in patients with benign and suspicious digital rectal examination (DRE) in our prostate biopsy cohort.
  
  
  METHODS
  Between 2009-2012, 759 consecutive initial transrectal systematic 12 cores prostate biopsies were included. PVs were calculated with transrectal ultrasound. Only prostate adenocarcinomas (PCa) were included into the study. For standardization, patients with missing data, and who have been exposed to any form of hormonal or radiation therapy were excluded. Patients were categorized with DRE (negative or positive) and Gleason sum [<7: low grade PCa(LGPCa), ≥7: HGPCa].
  
  
  RESULTS
  Median PV was significantly lower in patients with HGPCa. There was a significantly increased risk of HGPCa with PV according to all groups in univariate logistic regression (LR). The significant relationship continued in multivariate LR with PSA and age. From the ROC curve analyses, again a significantly statistical concordance was found between the detection of HGPCa and PV (AUC:0.63, p<0.001), as well as between HGPCa and tPSA (AUC:0.73, p<0.001). tPSA and PV were also significantly concordant with HGPCa both in DRE negative and positive patients.
  
  
  CONCLUSIONS
  There is a significant relationship between HGPCa and decreasing PV. The continued significant relationship both in DRE negative and positive patients reinforces this relation.
authors.affiliation: University of Kocaeli , School of Medicine, Urology Department, Kocaeli, Turkey.
authors.forename: Hasan
authors.initials: H
authors.lastname: Yilmaz
authors.affiliation: University of Kocaeli , School of Medicine, Urology Department, Kocaeli, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Ustuner
authors.affiliation: University of Kocaeli , School of Medicine, Urology Department, Kocaeli, Turkey.
authors.forename: Seyfettin
authors.initials: S
authors.lastname: Ciftci
authors.affiliation: University of Kocaeli , School of Medicine, Urology Department, Kocaeli, Turkey.
authors.forename: Ufuk
authors.initials: U
authors.lastname: Yavuz
authors.affiliation: Derince Training and Research Hospital, Urology Department, Kocaeli, Turkey.
authors.forename: Tayyar Alp
authors.initials: TA
authors.lastname: Ozkan
authors.affiliation: University of Kocaeli , School of Medicine, Urology Department, Kocaeli, Turkey.
authors.forename: Ozdal
authors.initials: O
authors.lastname: Dillioglugil
mesh_terms: D000368:Aged; D001706:Biopsy; D002277:Carcinoma / Q000000981:diagnostic imaging / Q000473:pathology*; D051517:Digital Rectal Examination / Q000379:methods*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D012372:ROC Curve; D012015:Reference Standards; D012189:Retrospective Studies; D012307:Risk Factors; D047368:Tumor Burden; D014463:Ultrasonography
chemical_list: D017430:Prostate-Specific Antigen