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 patients who underwent radical prostatectomy and who had a PSA level below 10 ng/mL and had not received hormone therapy.

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They reviewed data obtained from transrectal ultrasonography (TRUS)-guided biopsies and the radical prostatectomy specimens. The investigators defined high-grade tumors 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, the researchers reported in BJU International (online ahead of print). 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 due to lower PSA levels, and high-grade tumors are less differentiated and thus produce less detectable PSA.