The value of a first MRI and targeted biopsies after several years of active surveillance for low-risk prostate cancer – results from the SAMS trial

Carlsson, Stefan; Bratt, Ola; Kristiansson, Dushanka; Jäderling, Fredrik

doi:10.1080/21681805.2020.1788634

Cited by 2 publications

(2 citation statements)

References 18 publications

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“…Given the breadth of our study duration, we employed both standardized template TRUS biopsies and targeted MRI/TRUS fusion biopsies. While reclassification rates were not significantly different between the two procedures, there was a trend towards a higher reclassification rate in the fusion biopsy group, which is congruent with the prior efforts that demonstrated increased Gleason grade progression with the more sensitive and specific fusion biopsies [ 26 , 27 , 28 , 29 , 30 ].…”

Section: Discussionsupporting

confidence: 82%

Two Decades of Active Surveillance for Prostate Cancer in a Single-Center Cohort: Favorable Outcomes after Transurethral Resection of the Prostate

Hagmann

Ramakrishnan

Tamalunas

et al. 2022

Cancers

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Objective: To report the outcomes of active surveillance (AS) for low-risk prostate cancer (PCa) in a single-center cohort. Patients and Methods: This is a prospective, single-center, observational study. The cohort included all patients who underwent AS for PCa between December 1999 and December 2020 at our institution. Follow-up appointments (FU) ended in February 2021. Results: A total of 413 men were enrolled in the study, and 391 had at least one FU. Of those who followed up, 267 had PCa diagnosed by transrectal ultrasound (TRUS)-guided biopsy (T1c: 68.3%), while 124 were diagnosed after transurethral resection of the prostate (TURP) (T1a/b: 31.7%). Median FU was 46 months (IQR 25–90). Cancer specific survival was 99.7% and overall survival was 92.3%. Median reclassification time was 11.2 years. After 20 years, 25% of patients were reclassified within 4.58 years, 6.6% opted to switch to watchful waiting, 4.1% died, 17.4% were lost to FU, and 46.8% remained on AS. Those diagnosed by TRUS had a significantly higher reclassification rate than those diagnosed by TURP (p < 0.0001). Men diagnosed by targeted MRI/TRUS fusion biopsy tended to have a higher reclassification probability than those diagnosed by conventional template biopsies (p = 0.083). Conclusions: Our single-center cohort spanning over two decades revealed that AS remains a safe option for low-risk PCa even in the long term. Approximately half of AS enrollees will eventually require definitive treatment due to disease progression. Men with incidental prostate cancer were significantly less likely to have disease progression.

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Section: Discussionsupporting

confidence: 82%

Two Decades of Active Surveillance for Prostate Cancer in a Single-Center Cohort: Favorable Outcomes after Transurethral Resection of the Prostate

Hagmann

Ramakrishnan

Tamalunas

et al. 2022

Cancers

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show abstract

“…PSAd has also emerged as a powerful predictor of the future behaviour of disease. Studies have shown that in AS, it is a useful predictor of biopsy upgrading, aids MRI in predicting early reclassification, and informs repeat biopsy interval [35] , [36] , [37] . Remarkably, both our work and others’ works have demonstrated the key threshold of PSAd of ≥0.15 in differentiating future behaviour [11] , [38] , [39] .…”

Section: Discussionmentioning

confidence: 99%

Prospective Implementation and Early Outcomes of a Risk-stratified Prostate Cancer Active Surveillance Follow-up Protocol

Thankapannair

Keates

Barrett

et al. 2023

European Urology Open Science

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The value of a first MRI and targeted biopsies after several years of active surveillance for low-risk prostate cancer – results from the SAMS trial

Abstract: Jäderling (2020) The value of a first MRI and targeted biopsies after several years of active surveillance for low-risk prostate cancer-results from the SAMS trial,

Cited by 2 publications

References 18 publications

Two Decades of Active Surveillance for Prostate Cancer in a Single-Center Cohort: Favorable Outcomes after Transurethral Resection of the Prostate

Two Decades of Active Surveillance for Prostate Cancer in a Single-Center Cohort: Favorable Outcomes after Transurethral Resection of the Prostate

Prospective Implementation and Early Outcomes of a Risk-stratified Prostate Cancer Active Surveillance Follow-up Protocol

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