Mp05-17 Effect of Finasteride on the Incidence of Prostate Cancer Stratified by Prostate Gland Volume in the Prostate Cancer Prevention Trials (Pcpt)

You have accessJournal of UrologyProstate Cancer: Basic Research & Pathophysiology I (MP05)1 May 2024MP05-17 EFFECT OF FINASTERIDE ON THE INCIDENCE OF PROSTATE CANCER STRATIFIED BY PROSTATE GLAND VOLUME IN THE PROSTATE CANCER PREVENTION TRIALS (PCPT) Zheyar J. Seyan, John Wolpert, Stephanie Stroever, and Werner T. W. de Riese Zheyar J. SeyanZheyar J. Seyan , John WolpertJohn Wolpert , Stephanie StroeverStephanie Stroever , and Werner T. W. de RieseWerner T. W. de Riese View All Author Informationhttps://doi.org/10.1097/01.JU.0001008740.27639.cc.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Studies have shown that finasteride may decrease the incidence of prostate cancer (PCa) in general, but may increase the incidence of high-grade PCa. There have been many hypotheses attempting to explain this phenomenon, but the PCPT data have not yet been stratified based on prostate volume. In this study, we have investigated whether prostate volume is a confounding variable in the PCPT results. METHODS: After obtaining formal approval from the SWOG Cancer research group to analyze the PCPT data, patients from both the control group and those on finasteride treatment were included in the analysis. Inclusion criteria consisted of patients who had had biopsies with a confirmed cancer status. Patients without documented prostate volume measurements were excluded. Simple and multivariable logistic regression analyses including specific biographic parameters were applied. RESULTS: After applying these inclusion and exclusion criteria to the original 18,800 patients in the PCPT study, 10,279 patients, with a mean age of 63 years, were included in our analysis. For the cohort without finasteride (control), these patients with prostate volumes larger than 60 cc showed a statically significant reduction in PCa incidence when compared to those with small prostate volumes under 30 cc (p<0.001). However, under finasteride small and mid-sized prostates benefited, whereas patients with large prostate volumes (60 cc) had an increase incidence of PCa compared to the control, not only for all cancer but also for clinically significant PCa (Table 1). CONCLUSIONS: Our data show the prophylactic benefit of finasteride in PCa incidence reduction only for small and mid-sized prostates, whereas patients with large prostate volumes are exposed to higher risk when compared to control. This stratification by prostate volume explains the controversial data in the literature arguing about benefits of finasteride prophylaxis for patients. This not only applies for all PCa, but also for clinically significant PCa. This phenomenon may be related to the more pronounced volume reduction of the transition zone in large prostates under finasteride, thus allowing more space for the proliferation of the glandular tissue within the peripheral zone where 80-85% of PCa originates. Source of Funding: We have no financial disclosures © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e49 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Zheyar J. Seyan More articles by this author John Wolpert More articles by this author Stephanie Stroever More articles by this author Werner T. W. de Riese More articles by this author Expand All Advertisement PDF downloadLoading ...