Evidence map›Paper›PMID 28443144›Full record

ArticleCanadian Urological Association journal = Journal de l'Association des urologues du Canada

Modern-day prostate cancer is not meaningfully associated with lower urinary tract symptoms: Analysis of a propensity score-matched cohort.

Amar Bhindi, Bimal Bhindi, Girish S Kulkarni, Robert J Hamilton, Ants Toi, Theodorus H van der Kwast, Andrew Evans, Alexandre R Zlotta, Antonio Finelli, Neil E Fleshner

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Canadian Urological Association journal = Journal de l'Association des urologues du Canada. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
1.0field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 18 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Review
  5. Prostate Cancer in Primary Care.Advances in therapy · 2018
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

Amar BhindiDepartment of Medicine, McGill University, Montreal, QC, Canada.
Bimal BhindiDivision of Urology, Department of Surgery, University Health Network, University of Toronto, Toronto, ON, Canada.
Girish S KulkarniDivision of Urology, Department of Surgery, University Health Network, University of Toronto, Toronto, ON, Canada.
Robert J HamiltonDivision of Urology, Department of Surgery, University Health Network, University of Toronto, Toronto, ON, Canada.
Ants ToiDepartment of Medical Imaging, University Health Network, University of Toronto, Toronto, ON, Canada.
Theodorus H van der KwastDepartment of Pathology, University Health Network, University of Toronto, Toronto, ON, Canada.
Andrew EvansDepartment of Pathology, University Health Network, University of Toronto, Toronto, ON, Canada.
Alexandre R ZlottaDivision of Urology, Department of Surgery, University Health Network, University of Toronto, Toronto, ON, Canada.
Antonio FinelliDivision of Urology, Department of Surgery, University Health Network, University of Toronto, Toronto, ON, Canada.
Neil E FleshnerDivision of Urology, Department of Surgery, University Health Network, University of Toronto, Toronto, ON, Canada.
University Health Network · CAUniversity of Toronto · CAMcGill University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionWe sought to determine if prostate cancer (PCa) is associated with worse lower urinary tract symptoms (LUTS) than matched benign prostates, with attention to cancer characteristics, in a contemporary cohort.

methodsUsing a single-institution database (January 1, 2009-June 30, 2013), men diagnosed with PCa on biopsy and controls with negative biopsies were matched 1:1 on age, prostate volume, and a propensity score predicting the probability of PCa diagnosis. International Prostate Symptom Score (IPSS) was compared between PCa cases and controls using paired statistics, stratifying on grade, cancer volume, stage, and D'Amico risk group. Sensitivity analyses were performed separately, repeating the match for high-grade, high-volume, and high-stage cancers only, and excluding users of benign prostatic hyperplasia medications.

resultsIn our cohort of 1330 men (665 with PCa), there were 284 (42.7%) Gleason 6 cancers (Grade Group 1), 315 (47.4%) Gleason 7 cancers (Grade Group 2-3), and 66 (9.9%) Gleason 8-10 cancers (Grade Group 4-5). There was no difference in IPSS between PCa cases (median 6.5, interquartile range [IQR] 3-12) and benign controls (median 7, IQR 3-13; p=0.34). Subgroup analyses based on cancer grade, volume, or stage, showed no significant differences in IPSS between men with and without PCa, except among men with cT2b-cT4 PC (median 9, IQR 5-16) vs. matched benign counterparts (median 8, IQR 3-12; p=0.03). Sensitivity analyses supported these findings.

conclusionsModern PCa does not appear to be associated with worse LUTS compared to benign prostates of the same size. Outlet obstruction is likely a late event in the natural history of PCa. This has implications for timely PCa detection, which should ideally be prior to the onset of LUTS.

Identifiers

PMID28443144
PMCPMC5403675
OpenAlexW2589611707

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.