Identifying Candidates for Active Surveillance: An Evaluation of the Repeat Biopsy Strategy for Men with Favorable Risk Prostate Cancer

Barzell, Winston; Melamed, Myron R.; Cathcart, Paul; Moore, Caroline M.; Emberton, Mark

doi:10.1016/j.juro.2012.04.107

Cited by 79 publications

(38 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…et al,8 included a template with cores systematically obtained according to gland volume with an average of 1 core obtained per cc.Figures 1 and 2…”

mentioning

confidence: 99%

Transperineal Template Guided Prostate Biopsy Selects Candidates for Active Surveillance—How Many Cores are Enough?

et al. 2015

View full text Add to dashboard Cite

show abstract

“…et al,8 included a template with cores systematically obtained according to gland volume with an average of 1 core obtained per cc.Figures 1 and 2…”

mentioning

confidence: 99%

Transperineal Template Guided Prostate Biopsy Selects Candidates for Active Surveillance—How Many Cores are Enough?

et al. 2015

View full text Add to dashboard Cite

show abstract

“…11 To increase the precision of risk assignment, most centres now recommend a confirmatory biopsy or an extended-template biopsy before initiating AS. 12 Unfortunately, due to the retrospective nature of this study most patients did not receive a confirmatory biopsy.…”

Section: Discussionmentioning

confidence: 98%

Five-year follow-up of active surveillance for prostate cancer: A Canadian community-based urological experience

Andrews

Ashfield

Morse

et al. 2014

CUAJ

View full text Add to dashboard Cite

Cite as: Can Urol Assoc J 2014;8(11-12):e768-74. http://dx.doi.org/10.5489/cuaj.2186 Published online November 24, 2014. Abstract Introduction:We assessed oncological outcomes of active surveillance (AS) using a community database and identified factors associated with disease reclassification on surveillance biopsy. Methods: A retrospective review was performed on 200 men on AS. Prostate-specific antigen (PSA) was measured every 3 to 6 months. Prostate biopsies were performed every 1 to 4 years, and at the individual physician's discretion. Disease reclassification was defined as clinical T1 to cT2 progression, or histologically as >2 cores positive, Gleason score >6, or >50% core involvement on surveillance biopsy. Multivariate Cox regression analysis evaluated factors associated with disease reclassification. Kaplan-Meier survival curves were plotted. Results:We assessed a heterogeneous cohort of 86 patients, with a median age 67.2 years, who received ≥1 surveillance biopsies. The median follow-up was 5.2 years. The median times to first and second surveillance biopsies were 730 and 763 days, respectively. Overall, 47% of patients were reclassified on surveillance biopsy after a median 2.1 years. Factors associated with disease reclassification were PSA density >0.20 (p < 0.0001, hazard ratio [HR] 4.55, 95% confidence interval [CI] 2.116-9.782) and ≥3 positive cores (p = 0.0152, HR 3.956, 95% CI 1.304-12.003) at diagnosis, and number of positive cores on surveillance biopsy. In total, 25 (29%) patients received delayed intervention, with a median time to intervention of 2.6 years. The median time on AS was 4.4 years, with an overall survival of 95% and prostate-specific survival of 100%. Conclusions: Our community study supports AS to reduce overtreatment of prostate cancer. PSA density >0.20 and ≥3 cores positive are associated with disease reclassification on surveillance biopsy.

show abstract

“…To increase the accuracy of cancer classification, some authors recommend a repeat confirmatory biopsy at the beginning of AS, as up to one third of patients are undergraded [30] , but even this repeat biopsy may vary. So, transperineal template-guided prostate mapping reclassified PCa primarily eligible for AS in 41-85% depending on definition as clinically important cancers compared to 8-22% in case of conventional transrectal confirmatory biopsy (12-core scheme) [31] .…”

Section: Inclusion Criteria For Asmentioning

confidence: 99%

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

Augustin¹,

Mayerhofer²,

Seles³

et al. 2015

Urol Int

View full text Add to dashboard Cite

Background: Active surveillance (AS) represents an expectant treatment strategy for clinically localized prostate cancer (PCa) with low-risk features. Objective: The actual management as well as the pros and cons of AS were evaluated. Methods: A systematic review of the recent literature was performed using the Medline databases. Conclusions: Since a substantial number of men die with rather than from PCa, there is a considerable role for AS in carefully selected men. AS may also represent a strategy to reduce the burden of overtreatment rooted in intensified PSA testing. Facing the imprecision of risk stratification based on transrectal ultrasound-guided biopsy, accurate clinical staging represents a major medical challenge. Counseling and care require empathy as well as a profound understanding of the biology and the natural history of PCa.

show abstract

Identifying Candidates for Active Surveillance: An Evaluation of the Repeat Biopsy Strategy for Men with Favorable Risk Prostate Cancer

Cited by 79 publications

References 26 publications

Transperineal Template Guided Prostate Biopsy Selects Candidates for Active Surveillance—How Many Cores are Enough?

Transperineal Template Guided Prostate Biopsy Selects Candidates for Active Surveillance—How Many Cores are Enough?

Five-year follow-up of active surveillance for prostate cancer: A Canadian community-based urological experience

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

Contact Info

Product

Resources

About