Prostate weight and prostate cancer outcomes after radical prostatectomy: Results from the SEARCH cohort study

被引:5
作者
Barlow, Sean Kennedy [1 ]
Oyekunle, Taofik [2 ]
Janes, Jessica L. [1 ]
De Hoedt, Amanda M. [1 ]
Aronson, William J. [3 ,4 ]
Kane, Christopher J. [5 ,6 ]
Amling, Christopher L. [7 ]
Cooperberg, Matthew R. [8 ,9 ]
Klaassen, Zachary W. [10 ,11 ]
Terris, Martha K. [10 ,11 ]
Freedland, Stephen J. [1 ,12 ]
Csizmadi, Ilona [12 ]
机构
[1] Durham Vet Affairs Hlth Care Syst, Div Urol, Durham, NC USA
[2] Duke Univ, Duke Canc Inst Biostat Shared Resource, Dept Biostat & Bioinformat, Sch Med, Durham, NC USA
[3] Univ Calif Los Angeles, Med Ctr, Dept Urol, Los Angeles, CA 90024 USA
[4] Wadsworth Vet Affairs Med Ctr, Div Urol, Los Angeles, CA USA
[5] Univ Calif San Diego Hlth Syst, Dept Urol, San Diego, CA USA
[6] Vet Affairs San Diego Healthcare Syst, Div Urol, San Diego, CA USA
[7] Oregon Hlth & Sci Univ, Dept Urol, Portland, OR 97201 USA
[8] Univ Calif San Francisco, Dept Urol, Med Ctr, San Francisco, CA USA
[9] San Francisco VA Med Ctr, Div Urol, San Francisco, CA USA
[10] Augusta Univ, Dept Surg, Augusta, GA USA
[11] Charlie Norwood Vet Affairs Med Ctr, Div Urol, Augusta, GA USA
[12] Cedars Sinai Med Ctr, Dept Surg, Los Angeles, CA 90048 USA
基金
美国国家卫生研究院;
关键词
prostate cancer; prostate cancer outcomes; prostate weight; radical prostatectomy; SERUM TESTOSTERONE; BIOCHEMICAL RECURRENCE; RISK; SIZE; DIHYDROTESTOSTERONE; PREVENTION; ANDROGENS; VOLUME;
D O I
10.1002/pros.24283
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Smaller prostates have been linked to unfavorable clinical characteristics and poor short-term outcomes following radical prostatectomy (RP). We examined the relation between prostate weight at RP and prostate cancer (PC) outcomes post-RP. Methods Men in the SEARCH cohort undergoing RP between 1988 and 2017 (N = 6242) were studied for PC-specific mortality (PCSM) as the primary outcome, and for biochemical recurrence (BCR), castration-resistant PC (CRPC) and metastasis as secondary outcomes. Hazard ratios (HR) and 95% confidence intervals (CI) were determined for associations between prostate weight and outcomes using Fine-Gray competing risk regression multivariable analyses. Sensitivity analyses were also carried out following exclusion of: (i) men with extreme prostate weights (<20 g and >= 100 g); and (ii) men with elevated prostate specific antigen (PSA) levels. Results Median values for age, pre-RP PSA and prostate weight were 63 years, 6.6 ng/ml, and 42.0 g, respectively. During a median follow-up of 7.9 years, 153 (3%) died from PC, 2103 (34%) had BCR, 203 (3%) developed CRPC, and 289 (5%) developed metastases. Prostate weight was not associated with PCSM in the main analyses (multivariable HR = 1.43; 95% CI: 0.87-2.34) or in sensitivity analyses. Prostate weight was inversely associated with BCR in the main analyses (multivariable HR = 0.70; 95%CI: 0.61-0.79) which was unchanged in sensitivity analyses. HRs for prostate weight and CRPC and metastasis were elevated but statistical significance was not attained. Similar results were observed in sensitivity analyses. Conclusions Inconsistent results for prostate weight and short-term vs longer-term outcomes highlight the need to better understand the complex biology leading to prostate size and the relevance of prostate size as a predictor of PC outcomes.
引用
收藏
页码:366 / 372
页数:7
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