(HealthDay News) – For men with low-risk prostate cancer, prostate size is an independent predictor of Gleason score upgrading, according to a study published in the December issue of The Journal of Urology.

Judson Davies, MD, of the Vanderbilt University Medical Center in Nashville, TN, and colleagues investigated whether prostate size predicts Gleason score upgrading in 1,251 men with D’Amico low-risk prostate cancer. Participants underwent radical prostatectomies and were divided by pathological Gleason score into no, minor, and major Gleason score upgrading.

The researchers found that a total of 31% of cases were upgraded, including 26% with minor upgrading and 5% with major upgrading. Gleason score upgrading correlated with worse outcomes. Smaller prostate size was a significant, independent predictor of any upgrade (odds ratio [OR], 0.58) and major upgrade (OR, 0.67), on multivariate analysis. Data showed that men who had low prostate volume at the 25th percentile (36cm³) were 50% more likely to be upgraded for risk than those with prostate size at the 75th percentile (58cm³).

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“Smaller prostate size predicts Gleason score upgrading in men with clinically low-risk prostate cancer,” the authors write. “This is important information when counseling patients on management and prognosis.”

Several of the study authors disclosed financial ties to the pharmaceutical industry.

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