MP15-07 SERIAL ANATOMIC PROSTATE ULTRASOUND IMAGING DURING PROSTATE CANCER ACTIVE SURVEILLANCE

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Active Surveillance II1 Apr 2016MP15-07 SERIAL ANATOMIC PROSTATE ULTRASOUND IMAGING DURING PROSTATE CANCER ACTIVE SURVEILLANCE Mohamed Eltemamy, Michael Leapman, Janet Cowan, Katsuto Shinohara, Antonio Westphalen, and Peter Carroll Mohamed EltemamyMohamed Eltemamy More articles by this author , Michael LeapmanMichael Leapman More articles by this author , Janet CowanJanet Cowan More articles by this author , Katsuto ShinoharaKatsuto Shinohara More articles by this author , Antonio WestphalenAntonio Westphalen More articles by this author , and Peter CarrollPeter Carroll More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2531AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The local growth potential of untreated low-grade prostate cancers (PCa) is unknown, yet potentially impactful for the practice of active surveillance (AS). We aimed to evaluate the incidence, growth dynamics and clinical significance of changes in prostate lesions on serial transrectal ultrasound (TRUS) imaging among a large cohort of men with PCa managed with AS. METHODS The retrospective study included men with PCa managed with AS at the University of California, San Francisco from 1990 to 2014 who received a minimum of two TRUS studies. Inclusion criteria were prostate-specific antigen (PSA) ≤ 20, clinical stage≤ T2 and biopsy Gleason grade ≤ 3+4. We described the presence of hypoechoic lesions at diagnosis. Progression endpoints included increase in imaging stage, ≥ 50% increase in volume, and increase in number of sites (sextants) with apparent lesions. The relationship between TRUS progression and biopsy Gleason upgrade was assessed using univariate and multivariate logistic regression models. RESULTS Among 713 identified patients the median number of TRUS studies was 5 (IQR 3-8), median follow up was 54 months (IQR 30-87). 407(57%) patients had TRUS-evident lesions at baseline. 281 (39%) patients progressed on serial TRUS imaging, including 55 by size, 209 by number of lesion sites and 211 by stage (median time to progression: 15 months). TRUS progression was independently associated with biopsy upgrade (OR 1.97, 95%CI 1.36-2.86, p < 0.01). Higher percentage of positive biopsy cores were associated with a higher likelihood of progression on TRUS (HR: 1.16; CI; 1.06-1.26; p<0.01) CONCLUSIONS Local progression, as assessed with TRUS, occurred in 39% of men AS and was associated with Gleason upgrade at biopsy. The median time to TRUS progression suggests that a less intense surveillance protocol is still safe. Percentage of biopsy positive cores should be used in tailoring AS protocols. The correlation of TRUS progression with biopsy upgrade might alter imaging and biopsy rates in those patients. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e154 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Mohamed Eltemamy More articles by this author Michael Leapman More articles by this author Janet Cowan More articles by this author Katsuto Shinohara More articles by this author Antonio Westphalen More articles by this author Peter Carroll More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...