Predictive Factors for Progression in Patients with Clinical Stage T1a Prostate Cancer in the PSA Era

Descazeaud, A.; Peyromaure, Michaël; Salin, Ambroise; Amsellem-Ouazana, Delphine; Flam, T.; Viellefond, Annick; Debré, B; Zerbib, Marc

doi:10.1016/j.eururo.2007.06.020

Cited by 35 publications

(47 citation statements)

References 21 publications

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“…By contrast, there are few studies on patients with IPCa on AS and these are mostly retrospective. The results are similar: invasive treatment was reported in 19% of T1a tumours in a study by Descazeaud et al [10] and in 30% of T1a and T1b tumours in a study by Lee et al [11]. Recently, we reported on a cohort of patients with IPCa who were treated by AS in a prospective setting: 11.1% of the patients switched to invasive treatment after a mean follow-up of 26.5 months [12].…”

Section: Introductionsupporting

confidence: 67%

Active surveillance in localized prostate cancer: comparison of incidental tumours (T1a/b) and tumours diagnosed by core needle biopsy (T1c/T2a): results from the HAROW study

Herden

Wille

Weißbach³

2015

BJU International

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ObjectiveTo conduct a comparative prospective analysis of patients with incidental T1a/T1b prostate cancer (IPCa) and those with prostate cancer (PCa) diagnosed by core needle biopsy, treated by active surveillance (AS), with regard to inclusion criteria, progression and switch to deferred treatment. Patients and MethodsThe HAROW study is an observational outcomes research study on the management of localized PCa. Treating urologists reported clinical variables and information on therapy and clinical course of disease at 6-month intervals. With respect to therapy, only recommendations were made; the final decision on the therapeutic method rested with the treating physician. ResultsOut of 2 957 patients included in the HAROW study, 447 chose AS. The median follow-up was 28.3 months. T1a, T1b, T1c and T2a disease were diagnosed in 81, 18, 292 and 56 patients, respectively. Patients in the IPCa group had lower prostate-specific antigen (PSA) levels (4.2 vs 6.1 ng/mL) and more comorbidities than those diagnosed by core needle biospy. The IPCa group also had fewer re-biopsies (25.3 vs 43.2%) and fewer changes to invasive treatment (12.1 vs 25.9%). No significant differences were found with respect to the criteria for discontinuation, subsequent therapies and histological findings after radical prostatectomy. ConclusionUrologists are highly inclined to use AS as a therapeutic option in IPCa. More patients with IPCa than those diagnosed after core needle biopsy continued on AS, which was also associated with the indication for a re-biopsy being less stringently observed.

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Section: Introductionsupporting

confidence: 67%

Active surveillance in localized prostate cancer: comparison of incidental tumours (T1a/b) and tumours diagnosed by core needle biopsy (T1c/T2a): results from the HAROW study

Herden

Wille

Weißbach³

2015

BJU International

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“…Capitanio et al, studying the predictive factors related to the progression of incidental cancer, reported that PSA before and after surgery and the Gleason scores of resected tissues were important factors, while the stage of the disease such as T1a or T1b was not [12]. Descazeaud et al also reported that the predictive factors of progression of T1a cancer were PSA before and after surgery, prostate volume, resected weight and Gleason scores [4]. Melchiors et al pointed out that there was considerable disparity of Gleason scores between specimens obtained from TURP and those from radical prostatectomy [13].…”

Section: Discussionmentioning

confidence: 99%

“…Most incidental prostate cancers are low-volume and early stage ones, but there are actually some clinically important cancers that can be progressive [4,9]. Predictive factors of the clinically important incidental cancer have not been clarified because its biological behavior is still difficult to understand.…”

Section: Discussionmentioning

confidence: 99%

“…According to this classification, patients with T1a cancer are usually observed through periodical follow-up and patients with T1b cancer can be candidates of active treatment [3]. These simple criteria have become inappropriate because there are some patients with T1a disease which shows progression to advanced cancer [4]. The selection of proper management of T1a cancer still remains controversial and difficult because there are sometimes pT0 cancer and considerable number of insignificant cancer.…”

Section: Introductionmentioning

confidence: 99%

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Incidental Prostate Cancer: Predictors of Progression and Strategies of Management Based on Prostate-Specific Antigen

Morita¹,

Matsuura

2014

JCTR

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Abstract:We studied predictors for the progression of incidental prostate cancer (PCa) to optimize the management strategies that are still controversial in the era of prostate-specific antigen (PSA). We performed advanced transurethral resection of the prostate (TURP) in 995 patients with benign prostate hyperplasia (BPH). Of these, 226 patients (22.7%) had incidental PCa. Included in the present study were 146 patients followed up for two years or longer. In the treated group of 26 patients whose PSA elevated, we performed radical transurethral resection of PCa (TURPCa) in 23 patients, palliative TURP in one, and endocrine therapy in two. Between the observed and treated groups, statistical differences were noted in PSA related parameters: preoperative PSA (Pre PSA), PSA three months after surgery (Post PSA), % Post PSA/Pre PSA (%PSA ratio), and PSA density (PSAD). No differences were noted in the clinical stage (T1a, T1b) and Gleason scores. Of 23 patients underwent radical TURPCa, one had pT0 disease, one showed PSA failure, and 19 had stable PSA. It may be rational and practical to decide the treatment strategy of incidental PCa based on PSA changes before and after TURP rather than Gleason scores or clinical stages.

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“…El PSA posquirú rgico ha demostrado en varios estudios, ser un buen predictor, no solo para la presencia de tumor residual sino tambié n para la predicció n de recaída bioquímica 5,6,12 . En nuestra revisió n se realiza un estudio del PSA posquirú rgico que presenta diferencias estadísticamente significativas entre ambos subgrupos, de forma que los pacientes con PSA posquirú rgico mayor presentan mayor probabilidad de requerir tratamiento de rescate que los que presentan un PSA posquirú rgico menor.…”

Section: T1a T1bunclassified

Actitud expectante en el adenocarcinoma incidental de próstata

Pascual¹,

Sacoto²,

Villa³

et al. 2010

Actas Urol Esp

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Predictive Factors for Progression in Patients with Clinical Stage T1a Prostate Cancer in the PSA Era

Cited by 35 publications

References 21 publications

Active surveillance in localized prostate cancer: comparison of incidental tumours (T1a/b) and tumours diagnosed by core needle biopsy (T1c/T2a): results from the HAROW study

Active surveillance in localized prostate cancer: comparison of incidental tumours (T1a/b) and tumours diagnosed by core needle biopsy (T1c/T2a): results from the HAROW study

Incidental Prostate Cancer: Predictors of Progression and Strategies of Management Based on Prostate-Specific Antigen

Actitud expectante en el adenocarcinoma incidental de próstata

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