Final pathohistology after radical prostatectomy in patients eligible for active surveillance (AS)

Abstract

The presented results show that the current inclusion criteria for AS are insufficient. For many patients, the beginning of the necessary therapy is delayed. According to our data, the prostate volume, the preoperative Gleason Score, and the number of positive samples obtained by transrectal core needle biopsy have the highest predictive power with regard to aggressiveness and expansion of the tumor. Despite the consideration of all these preoperative parameters, the differentiation of the prostate carcinomas was underrated in a third of all cases. The expansion of the tumor within the prostate was underrated even in three fourths of the cases.

Current concepts in multiparametric magnetic resonance imaging for active surveillance of prostate cancer

“…Another issues related to AS is the underestimation of the real extent of the disease and aggressiveness based only on standard biopsy (SB) data. Approximately thirty percent of patients with low-risk PCa on initial biopsy have a Gleason score upgrade when treated by radical prostatectomy; thus, SB is associated with substantial misclassification that may lead to inappropriate selection of patients for AS and postponement of the necessary treatment 10 . Therefore, distinction of patients who have low-risk cancers and those who need immediate treatment is a serious challenge.…”

Management of low- and intermediate-risk prostate cancer

“…Lellig et al [2] and Billing et al [3] examine We believe that the advances in the management of lowand intermediate-risk prostate cancer we see today will enable us to offer personalized medicine to our patients tomorrow.…”