Outcomes of Active Surveillance after Initial Surveillance Prostate Biopsy

Kovac, Evan; Lieser, Gregory; Elshafei, Ahmed; Jones, J. Stephen; Klein, Eric A.; Stephenson, Andrew J.

doi:10.1016/j.juro.2016.07.072

Cited by 7 publications

(4 citation statements)

References 29 publications

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“…15, 16 Algorithm 8 (no treatment and at least one prostate biopsy after diagnosis) was selected because it has the highest specificity. The repeat biopsy was required to be at least one month after, but within 12 months of, prostate cancer diagnosis to capture a true “confirmatory biopsy.” 17 Finally, Algorithm 6 (no treatment, age less than 75 years, and comorbidity score less than 3) was selected because it has the second highest specificity while maintaining considerably more sensitivity than Algorithm 8.…”

Section: Methodsmentioning

confidence: 99%

National Trends in Active Surveillance for Prostate Cancer: Validation of Medicare Claims-based Algorithms

Modi

Kaufman

et al. 2018

Urology

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Section: Methodsmentioning

confidence: 99%

National Trends in Active Surveillance for Prostate Cancer: Validation of Medicare Claims-based Algorithms

Modi

Kaufman

et al. 2018

Urology

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“…Nine prospective studies of AS have included about 10 000 men [38] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] . The largest most mature studies are summarized in Table 3 .…”

Section: Expected Outcomesmentioning

confidence: 99%

“…The results of the Protect trial have recently been reported [52] . This was a randomized trial comparing active monitoring, radical prostatectomy, and external-beam radiotherapy [48] . The primary end point was prostate cancer mortality at 10 years.…”

Section: Expected Outcomesmentioning

confidence: 99%

Contemporary approach to active surveillance for favorable risk prostate cancer

Klotz

2019

Asian Journal of Urology

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The approach to favorable risk prostate cancer known as “active surveillance” was first described explicitly in 2002. This was a report of 250 patients managed with a strategy of expectant management, with serial prostate-specific antigen and periodic biopsy, and radical intervention advised for patients who were re-classified as higher risk. This was initiated as a prospective clinical trial, complete with informed consent, beginning in 2007. Thus, there are now 20 years of experience with this approach, which has become widely adopted around the world. In this chapter, we will summarize the biological basis for active surveillance, review the experience to date of the Toronto and Hopkins groups which have reported 15-year outcomes, describe the current approach to active surveillance in patients with Gleason score 3 + 3 or selected patients with Gleason score 3 + 4 with a low percentage of Gleason pattern 4 who may also be candidates, enhanced by the use of magnetic resonance imaging, and forecast future directions.

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“…However the risk of misclassification still exists. [13] It has been believed that low risk PCa does not need immediate intervention because of its low-risk potential for metastases. However, some men may initially appear to have low-risk disease but in fact they have disease reclassified to higher risk.…”

Section: Introductionmentioning

confidence: 99%

Is active surveillance an appropriate approach to manage prostate cancer patients with Gleason Score 3+3 who met the criteria for active surveillance?

Ghiasy¹,

Abedi

Moradi

et al. 2019

Turkish Journal of Urology

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Objective: Prostate cancer is one of the common malignant tumors in men worldwide. Nowadays it seems that Gleason Score 3+3 may not need definite treatment and some of the experts even ignore it as a cancer but we should be aware that in some patients with Gleason Score 3+3 there is a higher risk for harboring higher-grade cancer. We had done this study to evaluate patients with prostate cancer with Gleason Score 3+3 to determine the value of tumor volume in these cases. Material and methods:From September 2010 to October 2017, radical prostatectomy was done for 123 sequential patients with localized prostate cancer in two referral centers of Shahid Beheshti Medical University, Tehran, Iran, and 42 cases with Gleason Scores 3+3 which who were candidates for active surveillance were included in the study.Results: Thirty of 42 (71.4%) patients had significant tumor volumes (≥0/5 cm 3 ). When tumor volume was less than 0.5 cm 3 , none of the patients had extra prostatic tumor extension. In patients with tumor volume greater than 0.5 cm 3 , two cases (6.6%) had extra prostatic extension, 4 cases (13.3%) had positive margins, four cases (13.3%) reactive lymph nodes and 16 cases (53.3%) perineural invasion. Conclusion:We suggest that some patients with Gleason Score 3+3 have tumor volume >0.5 cm 3 who are considered having significant cancer pathology and active surveillance may not be appropriate approach to manage all cases with Gleason Score 3+3.

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Outcomes of Active Surveillance after Initial Surveillance Prostate Biopsy

Abstract: Patients on active surveillance with stable disease at the time of initial surveillance prostate biopsy may be appropriate candidates for less intensive surveillance prostate biopsy schedules.

Cited by 7 publications

References 29 publications

National Trends in Active Surveillance for Prostate Cancer: Validation of Medicare Claims-based Algorithms

National Trends in Active Surveillance for Prostate Cancer: Validation of Medicare Claims-based Algorithms

Contemporary approach to active surveillance for favorable risk prostate cancer

Is active surveillance an appropriate approach to manage prostate cancer patients with Gleason Score 3+3 who met the criteria for active surveillance?

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