Is There a Role for Active Surveillance in Low-Risk Prostate Cancer?

Augustin, Herbert; Mayerhofer, Katrin; Seles, Maximilian; Pummer, Karl

doi:10.1159/000371895

Cited by 5 publications

(5 citation statements)

References 57 publications

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“…3-6). Indeed, it has been shown that clinically localized PCA with low-risk features is best managed by AS (17, 18). However, accurate clinical stratification at diagnosis represents one of the most critical features of this strategy because of the high risk of disease reclassification, which involves 1 out of 3 patients.…”

Section: Discussionmentioning

confidence: 99%

Prostate Volume Index Stratified Prostate Cancer Risk in Patients Elected to a First Random Biopsy Set

Porcaro

Corsi

Luyk

et al. 2017

Tumori

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Section: Discussionmentioning

confidence: 99%

Prostate Volume Index Stratified Prostate Cancer Risk in Patients Elected to a First Random Biopsy Set

Porcaro

Corsi

Luyk

et al. 2017

Tumori

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“…Extensive literature reviews have shown that clinically localized PCA with low-risk features is best managed by AS, which is an active expectant treatment strategy [13,14] . However, inaccurate clinical stratification at diagnosis represents one of the most challenging features of this treatment strategy because of the high risk of disease reclassification, which involves 1 out of 3 patients.…”

Section: Discussionmentioning

confidence: 99%

Prostate Volume Index Associates with a Decreased Risk of Prostate Cancer: Results of a Large Cohort of Patients Elected to a First Biopsy Set

Porcaro

Novella²,

Cacciamani³

et al. 2016

Urol Int

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Background/Aims/Objectives: In patients elected to the first prostate biopsy set, the risk of prostate cancer (PCA) may be predicted by clinical factors. The aim of this study was to investigate on prostate volume index (PVI), defined as the ratio of volume of the transitional zone to the volume of the peripheral zone, and PCA risk. Methods: The study retrospectively evaluated 1,327 patients and included only the first biopsy set with 14 cores. PCA risk was assessed by using the multivariate logistic regression model. Results: The analysis evaluated 596 patients. The detection rate of PCA was 49%. Age, prostate specific antigen, PVI and digital rectal exam were independent factors of PCA risk, which was decreased by PVI (OR 0.224; 95% CI 0.157-0.380). The goodness of fit statistics assessed model efficacy. Conclusions: In a large cohort undergoing the first biopsy set, PVI associated with a decreased risk of PCA. Confirmatory studies are required.

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“…So far, AS may represent a strategy to reduce the burden of overtreatment due to intensified prostatespecific antigen (PSA) testing [5] . However, in AS protocols, inclusion criteria and appropriate methods for monitoring patients have not yet been standardized because of the evolving knowledge about PCA [6][7][8][9][10][11][12] .…”

Section: Clinical Factors Of Disease Reclassification or Progression mentioning

confidence: 99%

Clinical Factors of Disease Reclassification or Progression in a Contemporary Cohort of Prostate Cancer Patients Elected to Active Surveillance

Porcaro¹,

Cavicchioli²,

Mattevi³

et al. 2016

Urol Int

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Objectives: To evaluate clinical predictors of disease reclassification or progression (DR/P) in prostate cancer patients elected to active surveillance (AS). Material and Methods: Patients were assessed on the basis of DR/P criteria. Predictors of DR/P were evaluated by multivariate logistic regression and Cox proportional hazards. Results: The median DR/P free time was 16.5 months. DR/P was detected in 30 out of 84 cases (35.7%). In DR/P cases, the median prostate volume (PV) was significantly lower (34.7 vs. 42.7 ml) and the percentage of cases with 2 or 3 vs. 1 initial biopsy positive cores (BPC) was significantly higher (36.7 vs. 7.4%). The multivariate logistic regression model showed that PV (OR 0.9; p = 0.021) and initial n >1 BPC (OR 9.8; p = 0.001) were independent predictors of DR/P. By Cox multivariate proportional hazards, only n >1 BPC predicted early DR/P (hazard ratio 3.1; p = 0.003). Conclusions: In a contemporary cohort of patients elected to AS, independent factors stratifying the risk of DR/P were PV and initial BPC, which also predicted early DR/P. In patients elected to AS, the identification of risk factors of DR/P require early re-biopsy. Confirmatory studies are required.

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Is There a Role for Active Surveillance in Low-Risk Prostate Cancer?

Cited by 5 publications

References 57 publications

Prostate Volume Index Stratified Prostate Cancer Risk in Patients Elected to a First Random Biopsy Set

Prostate Volume Index Stratified Prostate Cancer Risk in Patients Elected to a First Random Biopsy Set

Prostate Volume Index Associates with a Decreased Risk of Prostate Cancer: Results of a Large Cohort of Patients Elected to a First Biopsy Set

Clinical Factors of Disease Reclassification or Progression in a Contemporary Cohort of Prostate Cancer Patients Elected to Active Surveillance

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