Active surveillance in males with low- to intermediate-risk localized prostate cancer: A modern prospective cohort study.

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State: Public
Version: Final published version
License: CC BY-NC 4.0
Serval ID
serval:BIB_11DA8B398364
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Active surveillance in males with low- to intermediate-risk localized prostate cancer: A modern prospective cohort study.
Journal
Investigative and clinical urology
Author(s)
Rakauskas A., Tawadros T., Lucca I., Herrera F., Bourhis J., Burruni R., Gomes M.N., Codeluppi C., Jolliet L., La Rosa S., Meuwly J.Y., Jichlinski P., Berthold D., Valerio M.
ISSN
2466-054X (Electronic)
ISSN-L
2466-0493
Publication state
Published
Issued date
07/2021
Peer-reviewed
Oui
Volume
62
Number
4
Pages
416-422
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
To compare the clinical outcome of males with low-risk and favorable intermediate-risk prostate cancer managed within a standardized modern protocol of active surveillance.
This was a prospective cohort study with strict and expanded active surveillance criteria in males with prostate cancer. Baseline assessment included multiparametric magnetic resonance imaging (mpMRI), extended systematic biopsy, and software-based MR-targeted biopsy. Follow-up included biannual prostate-specific antigen (PSA) check, mpMRI, and control biopsy once a year for the first 2 years, and afterward mpMRI every 2 years with additional tests as clinically indicated. The primary outcome was the transition rate to active treatment.
A total of 51 patients were included: 17 (33%) and 34 (67%) followed protocols of strict (study arm 1) and expanded (study arm 2) active surveillance criteria, respectively. Median age and PSA were 65 years (IQR, 60-69 years) and 5.3 ng/mL (IQR, 4.5-7.7 ng/mL), respectively. At baseline, a median of 2 (IQR, 1-3) cores were positive out of 13 (IQR, 12-14) cores; 22 males (43%) had visible mpMRI lesions. Eight males (24%) in study arm 2 had Gleason score 3+4. After a median follow-up of 36 months (IQR, 24-48 mo), no patient in study arm 1 compared with 17 patients (33%) in arm 2 underwent active treatment (p<0.0005).
Although expanding eligibility criteria leads to a greater transition rate to active treatment, active surveillance should be contemplated in well-selected males with favorable intermediate-risk prostate cancer as the curability window seems to be maintained.
Keywords
Active surveillance, Magnetic resonance imaging, Prostate cancer
Pubmed
Open Access
Yes
Create date
06/07/2021 10:14
Last modification date
20/07/2021 6:08
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