Interactions between benign prostatic hyperplasia (BPH) and prostate cancer in large prostates: a retrospective data review

PURPOSE - To study the interaction between benign prostatic hyperplasia (BPH) and prostate cancer (PCa).

METHODS - In this study, we performed a chart review of a cohort of 448 biopsy naive men. These men received a multi-core biopsy at our institution due to increased prostate-specific antigen (PSA) serum levels (>4 ng/ml) and/or suspicious findings on digital rectal examination in the years between 2008 and 2013.

Utilizing PSA and transrectal ultrasound (TRUS) prostate volume, we obtained the PSA density (PSAD) for each individual. PSAD was calculated by dividing serum PSA concentration by TRUS prostate volume.

RESULTS - Large prostates >65 g may secrete enough PSA to have a PSAD above the suggested cutoff of 0. 15, yet 50 % patients have no histologic evidence of PCa, whereas prostates

CONCLUSIONS - These results suggest that BPH in large prostates may be protective of PCa. The interaction of the different prostate zones, in particular the transition zone and peripheral zone, may play a significant role in the phenomenon observed in this study. However, sampling error may introduce bias that 12-16 core biopsies in larger prostates may be more likely missing the cancer lesion.

International urology and nephrology. 2015 Nov 21 [Epub ahead of print]

Shadi Al-Khalil, David Boothe, Trey Durdin, Sowmya Sunkara, Phillip Watkins, Shengping Yang, Allan Haynes, Werner de Riese

Department of Urology, Texas Tech University Health Sciences Center, 3601 4th St. , Suite 3B100, Lubbock, TX, 79430, USA. , Department of Urology, Texas Tech University Health Sciences Center, 3601 4th St. , Suite 3B100, Lubbock, TX, 79430, USA. , Department of Urology, Texas Tech University Health Sciences Center, 3601 4th St. , Suite 3B100, Lubbock, TX, 79430, USA. , Department of Urology, Texas Tech University Health Sciences Center, 3601 4th St. , Suite 3B100, Lubbock, TX, 79430, USA. , Department of Urology, Texas Tech University Health Sciences Center, 3601 4th St. , Suite 3B100, Lubbock, TX, 79430, USA. , Department of Urology, Texas Tech University Health Sciences Center, 3601 4th St. , Suite 3B100, Lubbock, TX, 79430, USA. , Department of Urology, Texas Tech University Health Sciences Center, 3601 4th St. , Suite 3B100, Lubbock, TX, 79430, USA. , Department of Urology, Texas Tech University Health Sciences Center, 3601 4th St. , Suite 3B100, Lubbock, TX, 79430, USA. 

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