Does size matter in prostate cancer? A cross-sectional study on genital dimensions in Caucasian men

¿Importa el tamaño en el cáncer de próstata? Un estudio transversal sobre las dimensiones genitales en hombres caucásicos

Background: Testosterone is crucial in male genital development during puberty. This study primarily aimed to compare genital size in Caucasian men with and without clinically significant prostate cancer (csPCa). The secondary aim was to assess genital size differences in csPCa patients stratified by tumor grade. Methods: We conducted an observational cross-sectional study on consecutive patients undergoing prostate biopsy. Each patient underwent systematic and cognitive-targeted transrectal biopsy. csPCa was defined as PCa with Gleason Score (GS) ≥7, tumor volume ≥0.5 cc, or extra-prostatic extension; other PCa and negative biopsies were classified as non-csPCa. Penile length was measured with the stretched test, and testicular volume by ultrasonography. Results: A total of 156 patients (64 csPCa and 92 non-csPCa) were enrolled. Median age was comparable between groups (68.9 vs. 66.6 years; p = 0.289). Median (IQR) stretched penile length (SPL) was 15.0 (14.0–16.3) cm in the csPCa group and 15.0 (13.0–15.2) cm in the non-csPCa group (p = 0.301). Median (IQR) right testicular volume was 12 (10–14) cc in both groups (p = 0.752), while left testicular volume was 10 (7–13) cc in the csPCa group and 12 (10–14) cc in the non-csPCa group (p = 0.172). Among csPCa patients, those with GS >7 had a longer SPL (16.0 (15–17) cm) compared to GS = 7 patients (14.5 (14–15) cm) (p = 0.012), with no significant differences in testicular volume. Conclusions: In Caucasian men, genital dimensions did not differ between those with and without csPCa. Within the csPCa group, longer SPL was observed in patients with higher-grade tumors. These findings suggest a possible association between genital size and tumor aggressiveness, which warrants further investigation.

Resumen

Antecedentes: La testosterona desempeña un papel fundamental en el desarrollo genital masculino durante la pubertad. El objetivo principal de este estudio fue comparar las dimensiones genitales en varones caucásicos con y sin cáncer de próstata clínicamente significativo (CPCs). Como objetivo secundario, se evaluaron las diferencias en las dimensiones genitales de los pacientes con CPCs estratificados según el grado tumoral. Métodos: Se llevó a cabo un estudio observacional y transversal en pacientes consecutivos sometidos a biopsia prostática . Todos los pacientes fueron sometidos a biopsia prostática sistemática y dirigida cognitiva por vía transrectal. El CPCs se definió como CP con puntuación de Gleason (GS) ≥7, volumen tumoral ≥0.5 cc o extensión extraprostática; el resto de los casos y las biopsias negativas se clasificaron como no CPCs. La longitud peneana en estiramiento (LPE) se midió clínicamente y el volumen testicular mediante ecografía. Resultados: Se incluyeron 156 pacientes (64 CPCs y 92 no CPCs). La mediana de edad fue comparable entre grupos (68.9 vs. 66.6 años; p = 0.289). La LPE mediana (RIQ) fue de 15.0 (14.0–16.3) cm en el grupo con CPCs y de 15.0 (13.0–15.2) cm en el grupo sin CPCs (p = 0.301). El volumen testicular derecho fue de 12 (10–14) cc en ambos grupos (p = 0.752), mientras que el izquierdo fue de 10 (7–13) cc en el grupo con CPCs y de 12 (10–14) cc en el grupo sin CPCs (p = 0.172). Entre los pacientes con CPCs, aquellos con GS >7 presentaron una LPE mediana (RIQ) de 16.0 (15–17) cm frente a 14.5 (14–15) cm en los pacientes con GS = 7 (p = 0.012), sin diferencias significativas en el volumen testicular. Conclusiones: En varones caucásicos, las dimensiones genitales no difirieron entre quienes presentaban o no CPCs. Sin embargo, dentro del grupo con CPCs, los pacientes con tumores de mayor grado mostraron una LPE más larga. Estos hallazgos sugieren una posible asociación entre el tamaño genital y la agresividad tumoral, que merece ser explorada en investigaciones futuras.

Androgens; Clinically significant prostate cancer; Penile length; Tumor grade

Palabras Clave

Andrógenos; Cáncer de próstata clínicamente significativo; Longitud peneana; Grado tumoral

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