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Association between prostate size and the incidence of prostate cancer: a meta-analysis and review for urologists and clinicians

  • Urology - Review
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Abstract

Purpose

To review the literature regarding any clinically significant association between prostate size and the incidence of prostate cancer (PCa). No previous review or meta-analysis has reported this clinical question.

Methods

A thorough literature review was performed using PubMed and applying the ‘PRISMA’ guidelines. Inclusion and exclusion criteria were defined.

Results

A total of 30 articles met the search criteria. Of these 30 articles, 27 reported an inverse correlation between prostate volume (PV) and incidence of biopsy-proven PCa. The remaining three articles provided no clear statistically significant results, and there was no study showing a direct or positive correlation between PV and the incidence of PCa.

Conclusion

This review and meta-analysis is the first report summarizing the literature on the clinical question of whether prostate size affects the incidence of PCa. Ninety percent of studies (27/30) show significant evidence supporting the hypothesis that prostate size may be protective of PCa. This review and the outlined discussion should encourage other clinical investigators to explore the relationship between PV and the incidence and aggressiveness of PCa. If future studies should confirm the hypothesis of the dynamic interactions between the different prostatic zones in a growing prostate, it will have relevant clinical implications on the management of BPH and PCa.

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Availability of data and materials

All data sets were extracted from PubMed.

Code availability

REVMAN software was used to quantify the various data sets.

Abbreviations

PCa:

Prostate cancer

BPH:

Benign prostatic hyperplasia

PV:

Prostate volume

TRUS:

Transrectal ultrasound

CG:

Central gland

TZ:

Transitional zone

PZ:

Peripheral zone

References

  1. Ørsted DD, Bojesen SE (2013) The link between benign prostatic hyperplasia and prostate cancer. Nat Rev Urol 10(1):49–54

    Article  Google Scholar 

  2. Siegel R, Naishadham D, Jemal A (2013) Cancer statistics, 2013. CA Cancer J Clin 63(1):11–30

    Article  Google Scholar 

  3. PRISMA (2021) http://www.prisma-statement.org/ Accessed 21 Feb 2021.

  4. Al-Azab R, Toi A, Lockwood G, Kulkarni GS, Fleshner N (2007) Prostate volume is strongest predictor of cancer diagnosis at transrectal ultrasound-guided prostate biopsy with prostatespecific antigen values between 2.0 and 9.0 ng/mL. Urology. 69(1):103–107

    Article  Google Scholar 

  5. Al-Khalil S, Ibilibor C, Cammack JT, de Riese W (2016) Association of prostate volume with incidence and aggressiveness of prostate cancer. Res Rep Urol 26(8):201–205

    Google Scholar 

  6. Karakiewicz PI, Bazinet M, Aprikian AG, Trudel C, Aronson S, Nachabé M, Péloquint F, Dessureault J, Goyal MS, Bégin LR, Elhilali MM (1997) Outcome of sextant biopsy according to gland volume. Urology 49(1):55–59

    Article  CAS  Google Scholar 

  7. Briganti A, Chun FK, Suardi N, Gallina A, Walz J, Graefen M, Shariat S, Ebersdobler A, Rigatti P, Perrotte P, Saad F, Montorsi F, Huland H, Karakiewicz PI (2007) Prostate volume and adverse prostate cancer features: fact not artifact. Eur J Cancer 43(18):2669–2677

    Article  CAS  Google Scholar 

  8. Hong SK, Poon BY, Sjoberg DD, Scardino PT, Eastham JA (2014) Prostate size and adverse pathologic features in men undergoing radical prostatectomy. Urology 84(1):153–157

    Article  Google Scholar 

  9. de Gorski A, Rouprêt M, Peyronnet B, Le Cossec C, Granger B, Comperat E, Cussenot O, Renard-Penna R, Mozer P (2015) Accuracy of magnetic resonance imaging/ultrasound fusion targeted biopsies to diagnose clinically significant prostate cancer in enlarged compared to smaller prostates. J Urol 194(3):669–673

    Article  Google Scholar 

  10. Peng Y, Shen D, Liao S, Turkbey B, Rais-Bahrami S, Wood B, Karademir I, Antic T, Yousef A, Jiang Y, Pinto PA, Choyke PL, Oto A (2015) MRI-based prostate volume-adjusted prostate- specific antigen in the diagnosis of prostate cancer. J Magn Reson Imaging 42(6):1733–1739

    Article  Google Scholar 

  11. Yilmaz H, Ustuner M, Ciftci S, Yavuz U, Ozkan TA, Dillioglugil O (2014) Prostate volume predicts high grade prostate cancer both in digital rectal examination negative (ct1c) and positive (≥ct2) patients. Int Braz J Urol 40(5):613–619

    Article  Google Scholar 

  12. Lorenzo G, Hughes TJR, Dominguez-Frojan P, Reali A, Gomez H (2019) Computer simulations suggest that prostate enlargement due to benign prostatic hyperplasia mechanically impedes prostate cancer growth. Proc Natl Acad Sci US A 116(4):1152–1161

    Article  CAS  Google Scholar 

  13. Guzman JA, Sharma P, Smith LA, Buie JD, de Riese WT (2019) Histological changes of the peripheral zone in small and large prostates and possible clinical implications. Res Rep Urol 21(11):77–81

    Google Scholar 

  14. Matsugasumi T, Fujihara A, Ushijima S, Kanazawa M, Yamada Y, Shiraishi T, Hongo F, Kamoi K, Okihara K, de Castro Abreu AL, Oishi M, Shin T, Palmer S, Gill IS, Ukimura O (2007) Morphometric analysis of prostate zonal anatomy using magnetic resonance imaging: impact on age-related changes in patients in Japan. BJU Int. https://doi.org/10.1111/bju.13823

    Article  Google Scholar 

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Funding

No specific grant was associated with this study.

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Authors

Contributions

WT.dR, JC, and AM contributed to the study conception and design. Material preparation, literature review, data collection, and analysis were mainly performed by AM. The first draft of the manuscript was written by AM and reviewed by WT.dR and JC. WT.dR and JC commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Jaime Camacho.

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Moolupuri, A., Camacho, J. & de Riese , W.T. Association between prostate size and the incidence of prostate cancer: a meta-analysis and review for urologists and clinicians. Int Urol Nephrol 53, 1955–1961 (2021). https://doi.org/10.1007/s11255-021-02892-w

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  • DOI: https://doi.org/10.1007/s11255-021-02892-w

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