Short‐term outcomes of the prospective multicentre ‘Prostate Cancer Research International: Active Surveillance’ study

Abstract

a Gleason score of ≤ 3 + 3 = 6, and one or two positive biopsy cores, were analysed. The follow-up protocol consisted of frequent PSA measurements, digital rectal examinations, and standard repeat biopsies (the first after 1 year). The primary outcome is survival free of active therapy; the secondary endpoints are reasons for stopping AS, findings in 1-year repeat biopsies, and outcomes after radical prostatectomy (RP). RESULTSPatients were included between December 2006 and July 2008. The median (25-75th percentile) follow-up after diagnosis was 1.02 (0.6-1.5) years. The 2-year survival rate free from active therapy was 73%. Of the 82 men who changed to active therapy during the follow-up, 68 (83%) did so based on the protocol. Of the 261 repeat biopsies available for analysis, 90 (34%) showed no cancer, while 57 (22%) showed a Gleason score of > 6 or more than two positive biopsy cores. There was a relatively unfavourable PSA doubling time of 0-10 years in 53% (102/194) and 62% (33/53) of men with favourable and unfavourable re-biopsy results, respectively. After RP, four of 24 (17%) men had T3 disease and 12 (50%) had a Gleason score of > 6. CONCLUSIONAS seems feasible, but mortality outcomes are unknown. A strict follow-up protocol including standard 1-year repeat biopsies resulted in a quarter of men stopping AS after 2 years.

Active Surveillance for Prostate Cancer: A Systematic Review of the Literature

“…Criteria for AS set forth from published series are shown in Table 1 [7][8][9][10][11][12][13][14][15]. First described in 1994, and then updated in 2004, the Epstein criteria integrate biopsy criteria with clinical data to identify potentially low-risk tumors and are among the most commonly used methods to identify lowrisk disease [16,17].…”

Active Surveillance for Prostate Cancer: Patient Selection and Management

“…Current OnCOlOgy-VOlume 17, Supplement 2 SURVEILLANCE FOR PROSTATE CANCER patients [6][7][8][9][10][11][12][13][14] . Certain observations emerge from these data.…”

PSA-based prostate cancer screening: the role of active surveillance and informed and shared decision making

“…2 Despite their indolent character, these low-risk tumors are often actively treated, resulting in so-called overtreatment. 19 Within the first round of the ERSPC (section Rotterdam), e.g. 293 out of 1014 men with detected PC could be classified as potentially overdiagnosed or 'indolent' and were eligible for active surveillance (AS).…”

“…The first study interim analysis is based on the initial 500 study inclusions. These patients were included between December 2006 and July 2008 with a median follow-up time of 1.02 year (IQR (interquartile range) 0.6-1.5 years) 19 The 2-year active therapy-free survival rate accounted for 73%. Eighty-two men changed to active therapy during follow-up; 83% (68/82) did so on protocol basis.…”

“…When applying the strict PRIAS inclusion and follow-up protocol the result is that one out of four men who start on AS switch to active therapy within 2 years after diagnosis. 19 The PRIAS study is still young and further follow-up data need to be obtained and analyzed. However, the first results look promising.…”