Impact of prostate volume on the active surveillance in prostate cancer

Objective: To determine the influence of the prostate volume (PVo) in the management of patients in active surveillance (AS) for prostate cancer. Materials and methods: A retrospective analysis of clinical, biological, histological and radiological data collected between 2010 and 2021 was performed for patients included in an AS protocol in a university hospital. The impact of initial PVo on the subsequent risk of exiting AS was evaluated. Results: In total, 109 patients were included in this analysis with a mean follow-up period of 52.74 ± 31 months, 50% were out of AS by the end of the follow-up period. The risk of exiting the AS protocol was significantly associated to the PVo: patients with smaller PVo had an increased risk of exiting AS ( p = 0.025). The maximal percentage of core invasion was the only initial predictive parameter for exiting the AS protocol on multivariate analysis of the global cohort ( p = 0.010) and in the sub-group of patients having PVo ⩽ 45 mL ( p = 0.013). In the group having a PVo > 45 mL, no single initial parameter was significantly associated to a risk of exiting AS. Conclusion: Patients having small-sized prostate seemed to be at higher risk of exiting AS during follow-up. Level of evidence: 4