No abstract

Our preliminary findings suggest that the 4Kscore may be a useful tool in the decision-making process to perform a confirmatory Bx in active surveillance management.

No abstract

No abstract

INTRODUCTION AND OBJECTIVES: Inclusion of MRI for patients selection for active surveillance (AS) allowed reclassification of 10% of intermediate or high-risk cancer at entry. Are confirmatory biopsies (CB) still necessary at one year for these patients? The main objective of our study is to compare the curative treatment rate between 2 groups with or without confirmatory biopsies at 1 year. Secondary objectives are to study PSA velocity (PSAV) and PSA doubling time (PSADT) performance for progression and to compare the 2-year tumour progression rate.METHODS: Retrospective monocentric cohort study. The included patients had a low risk cancer (1-2 positive biopsies, maximum cancer core length ¼ 5mm and no grade 4), a non-visible tumour at MRI or suspicious lesion at MRI with negative TB and followed for 1-year minimum. Some patients had confirmatory biopsies at one year (group 1) and others -the most recent-did not (group 2). Diagnostic tests for tumour progression/reclassification during follow-up were PSAV> 0.75 ng/ml/ year, emergence of a lesion at MRI, progression of extent and grade of tumour at for cause or per protocol biopsies. The comparisons of the event rates between the two groups were performed using the log-rank test.RESULTS: Out of 138 patients, 78 were included in group 1 (median follow-up 35 months; IQR (19-58) and 60 in group 2 (median follow-up 27.5; months IQR (19-48). There was no significant difference in curative treatment rate between groups 1 and 2 (24.8% vs. 18.3%) (p ¼0.19) (Figure1), and in tumour progression rate (17.4% vs 11.4%) (p ¼0.33). The area under the PSADT and PSAV curves to predict the PCa progression was 0.83 and 0.92, respectively (figure 2).CONCLUSIONS: It appears that curative treatment rate is not different between the 2 groups with or without confirmatory biopsies at 1 year. The PSA kinetics is accurate as a diagnostic test for PCa progression under AS.