Peripheral zone inflammation is not strongly associated with lower urinary tract symptom incidence and progression in the placebo arm of the prostate cancer prevention trial

Ibrahim Kulac, Berrak Gumuskaya, Charles G. Drake, Beverly Gonzalez, Kathryn B. Arnold, Phyllis J. Goodman, Alan R. Kristal, M. Scott Lucia, Ian M. Thompson, William B. Isaacs, Angelo M. De Marzo, Elizabeth A. Platz

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

BACKGROUND: Intraprostatic inflammation has been associated with lower urinary tract symptom (LUTS) progression. However, prior studies used tissue removed for clinical indications, potentially skewing inflammation extent or biasing the association. We, therefore, evaluated inflammation and LUTS incidence and progression in men who underwent biopsy of the prostate peripheral zone irrespective of indication. MATERIALS AND METHODS: We developed nested case-control sets in men in the placebo arm of the Prostate Cancer Prevention Trial who were free of clinical BPH and had a protocol-directed year 7 biopsy. Cases had baseline IPSS <15 and year 7 IPSS of 8-14 (low, N=47), 15-19 (incident moderate, N=42), or ≥20 (incident high, N=44). Controls had baseline and year 7 IPSS <8 (N=41). For progression from IPSS <8, cases had baseline to year 7 IPSS slope >75th percentile (N=46) and controls had a slope <25th percentile (N=45). For progression from IPSS=8-14, cases had a slope >75th percentile (N=46) and controls had a slope<25th percentile (N=46). We reviewed three H&E-stained biopsy cores per man to determine prevalence of ≥1 core with inflammation and mean extent (%) of tissue area with inflammation. RESULTS: Inflammation prevalence in low cases (64%) was similar to controls (66%), but higher in moderate (69%) and high (73%) cases (P-trend=0.4). Extent did not differ across LUTS categories (P-trend=0.5). For progression from IPSS<8, prevalence (65%, P=0.9) and extent (2.5%, P=0.8) in cases did not differ from controls (64%, 2.7%). For progression from IPSS 8-14, prevalence in cases (52%) was lower than in controls (78%, P=0.009), while extent was higher in cases (5.3%) than controls (3.6%), especially in men with ≥1 core with inflammation (10.1% versus 4.6%, P=0.06). CONCLUSION: Peripheral zone intraprostatic inflammation is not strongly associated with LUTS incidence or progression.

Original languageEnglish (US)
JournalProstate
DOIs
StateAccepted/In press - 2016

Fingerprint

Lower Urinary Tract Symptoms
Prostatic Neoplasms
Placebos
Inflammation
Incidence
Biopsy
Prostate

Keywords

  • Incidence
  • Inflammation
  • Lower urinary tract symptoms
  • Progression
  • Prostate

ASJC Scopus subject areas

  • Medicine(all)
  • Oncology
  • Urology

Cite this

Peripheral zone inflammation is not strongly associated with lower urinary tract symptom incidence and progression in the placebo arm of the prostate cancer prevention trial. / Kulac, Ibrahim; Gumuskaya, Berrak; Drake, Charles G.; Gonzalez, Beverly; Arnold, Kathryn B.; Goodman, Phyllis J.; Kristal, Alan R.; Lucia, M. Scott; Thompson, Ian M.; Isaacs, William B.; De Marzo, Angelo M.; Platz, Elizabeth A.

In: Prostate, 2016.

Research output: Contribution to journalArticle

Kulac, I, Gumuskaya, B, Drake, CG, Gonzalez, B, Arnold, KB, Goodman, PJ, Kristal, AR, Lucia, MS, Thompson, IM, Isaacs, WB, De Marzo, AM & Platz, EA 2016, 'Peripheral zone inflammation is not strongly associated with lower urinary tract symptom incidence and progression in the placebo arm of the prostate cancer prevention trial', Prostate. https://doi.org/10.1002/pros.23224
Kulac, Ibrahim ; Gumuskaya, Berrak ; Drake, Charles G. ; Gonzalez, Beverly ; Arnold, Kathryn B. ; Goodman, Phyllis J. ; Kristal, Alan R. ; Lucia, M. Scott ; Thompson, Ian M. ; Isaacs, William B. ; De Marzo, Angelo M. ; Platz, Elizabeth A. / Peripheral zone inflammation is not strongly associated with lower urinary tract symptom incidence and progression in the placebo arm of the prostate cancer prevention trial. In: Prostate. 2016.
@article{4deb49d618d6451288610c9581cad4e3,
title = "Peripheral zone inflammation is not strongly associated with lower urinary tract symptom incidence and progression in the placebo arm of the prostate cancer prevention trial",
abstract = "BACKGROUND: Intraprostatic inflammation has been associated with lower urinary tract symptom (LUTS) progression. However, prior studies used tissue removed for clinical indications, potentially skewing inflammation extent or biasing the association. We, therefore, evaluated inflammation and LUTS incidence and progression in men who underwent biopsy of the prostate peripheral zone irrespective of indication. MATERIALS AND METHODS: We developed nested case-control sets in men in the placebo arm of the Prostate Cancer Prevention Trial who were free of clinical BPH and had a protocol-directed year 7 biopsy. Cases had baseline IPSS <15 and year 7 IPSS of 8-14 (low, N=47), 15-19 (incident moderate, N=42), or ≥20 (incident high, N=44). Controls had baseline and year 7 IPSS <8 (N=41). For progression from IPSS <8, cases had baseline to year 7 IPSS slope >75th percentile (N=46) and controls had a slope <25th percentile (N=45). For progression from IPSS=8-14, cases had a slope >75th percentile (N=46) and controls had a slope<25th percentile (N=46). We reviewed three H&E-stained biopsy cores per man to determine prevalence of ≥1 core with inflammation and mean extent ({\%}) of tissue area with inflammation. RESULTS: Inflammation prevalence in low cases (64{\%}) was similar to controls (66{\%}), but higher in moderate (69{\%}) and high (73{\%}) cases (P-trend=0.4). Extent did not differ across LUTS categories (P-trend=0.5). For progression from IPSS<8, prevalence (65{\%}, P=0.9) and extent (2.5{\%}, P=0.8) in cases did not differ from controls (64{\%}, 2.7{\%}). For progression from IPSS 8-14, prevalence in cases (52{\%}) was lower than in controls (78{\%}, P=0.009), while extent was higher in cases (5.3{\%}) than controls (3.6{\%}), especially in men with ≥1 core with inflammation (10.1{\%} versus 4.6{\%}, P=0.06). CONCLUSION: Peripheral zone intraprostatic inflammation is not strongly associated with LUTS incidence or progression.",
keywords = "Incidence, Inflammation, Lower urinary tract symptoms, Progression, Prostate",
author = "Ibrahim Kulac and Berrak Gumuskaya and Drake, {Charles G.} and Beverly Gonzalez and Arnold, {Kathryn B.} and Goodman, {Phyllis J.} and Kristal, {Alan R.} and Lucia, {M. Scott} and Thompson, {Ian M.} and Isaacs, {William B.} and {De Marzo}, {Angelo M.} and Platz, {Elizabeth A.}",
year = "2016",
doi = "10.1002/pros.23224",
language = "English (US)",
journal = "Prostate",
issn = "0270-4137",
publisher = "Wiley-Liss Inc.",

}

TY - JOUR

T1 - Peripheral zone inflammation is not strongly associated with lower urinary tract symptom incidence and progression in the placebo arm of the prostate cancer prevention trial

AU - Kulac, Ibrahim

AU - Gumuskaya, Berrak

AU - Drake, Charles G.

AU - Gonzalez, Beverly

AU - Arnold, Kathryn B.

AU - Goodman, Phyllis J.

AU - Kristal, Alan R.

AU - Lucia, M. Scott

AU - Thompson, Ian M.

AU - Isaacs, William B.

AU - De Marzo, Angelo M.

AU - Platz, Elizabeth A.

PY - 2016

Y1 - 2016

N2 - BACKGROUND: Intraprostatic inflammation has been associated with lower urinary tract symptom (LUTS) progression. However, prior studies used tissue removed for clinical indications, potentially skewing inflammation extent or biasing the association. We, therefore, evaluated inflammation and LUTS incidence and progression in men who underwent biopsy of the prostate peripheral zone irrespective of indication. MATERIALS AND METHODS: We developed nested case-control sets in men in the placebo arm of the Prostate Cancer Prevention Trial who were free of clinical BPH and had a protocol-directed year 7 biopsy. Cases had baseline IPSS <15 and year 7 IPSS of 8-14 (low, N=47), 15-19 (incident moderate, N=42), or ≥20 (incident high, N=44). Controls had baseline and year 7 IPSS <8 (N=41). For progression from IPSS <8, cases had baseline to year 7 IPSS slope >75th percentile (N=46) and controls had a slope <25th percentile (N=45). For progression from IPSS=8-14, cases had a slope >75th percentile (N=46) and controls had a slope<25th percentile (N=46). We reviewed three H&E-stained biopsy cores per man to determine prevalence of ≥1 core with inflammation and mean extent (%) of tissue area with inflammation. RESULTS: Inflammation prevalence in low cases (64%) was similar to controls (66%), but higher in moderate (69%) and high (73%) cases (P-trend=0.4). Extent did not differ across LUTS categories (P-trend=0.5). For progression from IPSS<8, prevalence (65%, P=0.9) and extent (2.5%, P=0.8) in cases did not differ from controls (64%, 2.7%). For progression from IPSS 8-14, prevalence in cases (52%) was lower than in controls (78%, P=0.009), while extent was higher in cases (5.3%) than controls (3.6%), especially in men with ≥1 core with inflammation (10.1% versus 4.6%, P=0.06). CONCLUSION: Peripheral zone intraprostatic inflammation is not strongly associated with LUTS incidence or progression.

AB - BACKGROUND: Intraprostatic inflammation has been associated with lower urinary tract symptom (LUTS) progression. However, prior studies used tissue removed for clinical indications, potentially skewing inflammation extent or biasing the association. We, therefore, evaluated inflammation and LUTS incidence and progression in men who underwent biopsy of the prostate peripheral zone irrespective of indication. MATERIALS AND METHODS: We developed nested case-control sets in men in the placebo arm of the Prostate Cancer Prevention Trial who were free of clinical BPH and had a protocol-directed year 7 biopsy. Cases had baseline IPSS <15 and year 7 IPSS of 8-14 (low, N=47), 15-19 (incident moderate, N=42), or ≥20 (incident high, N=44). Controls had baseline and year 7 IPSS <8 (N=41). For progression from IPSS <8, cases had baseline to year 7 IPSS slope >75th percentile (N=46) and controls had a slope <25th percentile (N=45). For progression from IPSS=8-14, cases had a slope >75th percentile (N=46) and controls had a slope<25th percentile (N=46). We reviewed three H&E-stained biopsy cores per man to determine prevalence of ≥1 core with inflammation and mean extent (%) of tissue area with inflammation. RESULTS: Inflammation prevalence in low cases (64%) was similar to controls (66%), but higher in moderate (69%) and high (73%) cases (P-trend=0.4). Extent did not differ across LUTS categories (P-trend=0.5). For progression from IPSS<8, prevalence (65%, P=0.9) and extent (2.5%, P=0.8) in cases did not differ from controls (64%, 2.7%). For progression from IPSS 8-14, prevalence in cases (52%) was lower than in controls (78%, P=0.009), while extent was higher in cases (5.3%) than controls (3.6%), especially in men with ≥1 core with inflammation (10.1% versus 4.6%, P=0.06). CONCLUSION: Peripheral zone intraprostatic inflammation is not strongly associated with LUTS incidence or progression.

KW - Incidence

KW - Inflammation

KW - Lower urinary tract symptoms

KW - Progression

KW - Prostate

UR - http://www.scopus.com/inward/record.url?scp=84978412141&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84978412141&partnerID=8YFLogxK

U2 - 10.1002/pros.23224

DO - 10.1002/pros.23224

M3 - Article

JO - Prostate

JF - Prostate

SN - 0270-4137

ER -