High-Grade Tumors More Likely in Smaller Prostates

BJU Int. 2008;102:563-565

High-grade tumors are more likely to be found in smaller prostates, according to researchers in Spain.

Maria Carmen Mir, MD, and her collaborators at Vall d'Hebron Hospital in Barcelona studied 390 radical prostatectomy patients who had a PSA level below 10 ng/mL and had not received hormone therapy. The investigators reviewed data obtained from transrectal ultrasonography-guided biopsies and the radical prostatectomy specimens. High-grade tumors were defined as having a Gleason score of 7 or higher.

In the biopsy, the proportion of prostates harboring Gleason 7 or higher disease was 52% at a prostate volume below 30 mL versus 26% when the prostate volume was greater than 50 mL. For the radical prostatectomy specimens, the proportions were 69% and 39%, respectively.

According to researchers, this association appears logical because smaller prostates generally are evaluated less closely by clinicians since they have lower PSA levels and high-grade tumors are less differentiated and thus produce less detectable PSA.