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

  • Urology - Original Paper
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Abstract

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 <35 g and an elevated PSAD of above 0.15 will have histologic evidence of PCa 70 % of the time.

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.

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Acknowledgement

We would like to acknowledge the Clinical Research Office at Texas Tech University Health Science Center in supporting the IRB application.

Funding

This study was funded by Texas Tech University Health Sciences Center, Department of Urology. No specific grant was associated with this study. IRB #: L14-107.

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Authors and Affiliations

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

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

Authors
  1. Shadi Al-Khalil
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  2. David Boothe
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  3. Trey Durdin
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  4. Sowmya Sunkara
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  5. Phillip Watkins
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  6. Shengping Yang
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  7. Allan Haynes
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  8. Werner de Riese
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Corresponding author

Correspondence to Werner de Riese.

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Al-Khalil, S., Boothe, D., Durdin, T. et al. Interactions between benign prostatic hyperplasia (BPH) and prostate cancer in large prostates: a retrospective data review. Int Urol Nephrol 48, 91–97 (2016). https://doi.org/10.1007/s11255-015-1146-2

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  • DOI: https://doi.org/10.1007/s11255-015-1146-2

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