Pd26-03 the Effect of Prostate Volume on Grade Progression and Treatment Decisions in Men With Benign Prostatic Hyperplasia and Prostate Cancer on Active Surveillance

You have accessJournal of UrologyProstate Cancer: Localized: Active Surveillance II (PD26)1 May 2024PD26-03 THE EFFECT OF PROSTATE VOLUME ON GRADE PROGRESSION AND TREATMENT DECISIONS IN MEN WITH BENIGN PROSTATIC HYPERPLASIA AND PROSTATE CANCER ON ACTIVE SURVEILLANCE David Ali, Michael Rezaee, Yuezhou Jing, Sean Fletcher, Patricia Landis, Mufaddal Mamawala, Naren Nimmagadda, and Christian P. Pavlovich David AliDavid Ali , Michael RezaeeMichael Rezaee , Yuezhou JingYuezhou Jing , Sean FletcherSean Fletcher , Patricia LandisPatricia Landis , Mufaddal MamawalaMufaddal Mamawala , Naren NimmagaddaNaren Nimmagadda , and Christian P. PavlovichChristian P. Pavlovich View All Author Informationhttps://doi.org/10.1097/01.JU.0001008556.20565.76.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Prostate volume is often used to inform the need and type of treatment required for symptomatic benign prostatic hyperplasia (BPH). However, the influence of prostate volume on treatment decisions in men with both symptomatic BPH and prostate cancer (PCa) on active surveillance (AS) is unknown. METHODS: Our AS registry was queried for the years 2000 to 2022. Patients were grouped by prostate volume measured by ultrasound at the time of their confirmatory biopsy (CBx): < 30 cc, 30 to £ 80 cc, and>80 cc. We controlled for baseline characteristics and clinically relevant factors. Bladder outlet procedures along with rates of cancer progression were compared between groups using multivariable logistic regression. RESULTS: Of 2,055 patients, 13.7% had prostate volumes<30 cc, while 72.7% and 13.7% had volumes 30 to £ 80 cc, and>80 cc, respectively. Men in the largest prostate volume group upgraded to GG2+ at a lower rate (21% vs 31-32%), but there were no differences in upgrading to GG3+ by prostate volume group. There was concomitantly less definitive treatment for prostate cancer in the largest prostate volume group, but a higher rate of bladder outlet procedures. On multivariable analysis, largest prostate volume group remained an independent predictor protective of upgrading to GG2+ and was associated with twice as many bladder outlet procedures, but was not associated with different rates of treatment for prostate cancer. Use of BPH medication did differ by prostate size but was not statistically significant among men undergoing bladder outlet procedures. CONCLUSIONS: PCa patients on AS with glands >80cc were significantly less likely to upgrade than patients with smaller glands, more likely to undergo bladder outlet procedures, and equally likely to undergo definitive PCa therapy. Other triggers for definitive PCa therapy may exist in these men such as high PSA, and the ability to offer a two-for-one approach to BPH and PCa treatment with radical prostatectomy, which merit further study. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e544 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information David Ali More articles by this author Michael Rezaee More articles by this author Yuezhou Jing More articles by this author Sean Fletcher More articles by this author Patricia Landis More articles by this author Mufaddal Mamawala More articles by this author Naren Nimmagadda More articles by this author Christian P. Pavlovich More articles by this author Expand All Advertisement PDF downloadLoading ...