Abstract
You have accessJournal of UrologyCME1 Apr 2023MP38-13 HAS ACTIVE SURVEILLANCE OF PROSTATE CANCER BECOME SAFER? LESSONS LEARNED FROM A GLOBAL CLINICAL REGISTRY: MOVEMBER GAP3 CONSORTIUM Paul Doan, Lin Zhu, Sebastiaan Remmers, Daan Nieboer, Jozien Helleman, Peter Carroll, Kyochul Koo, Andrew Hayen, James Thompson, and Chris Bangma Paul DoanPaul Doan More articles by this author , Lin ZhuLin Zhu More articles by this author , Sebastiaan RemmersSebastiaan Remmers More articles by this author , Daan NieboerDaan Nieboer More articles by this author , Jozien HellemanJozien Helleman More articles by this author , Peter CarrollPeter Carroll More articles by this author , Kyochul KooKyochul Koo More articles by this author , Andrew HayenAndrew Hayen More articles by this author , James ThompsonJames Thompson More articles by this author , and Chris BangmaChris Bangma More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003276.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Active Surveillance (AS) has matured into a widely applied treatment for low-intermediate risk prostate cancer (PCa). The safety of AS protocols has always been a key concern due to the risk of missing progression. This concern is reflected in national statistics for the uptake of AS which vary widely, in Europe 75-95% of low-risk cancers are treated with AS, in Australia 71%, in the USA 50% and in Asia 10-56%. Potentially, diagnostic tools such as mpMRI have improved the safety of AS protocols. This study aims to describe the evolution of AS protocols overtime including criteria for selection and long-term clinical outcomes for over 26000 patients in the GAP3 database. Thus, assessing the safety and acceptability of AS as a treatment for PCa. METHODS: From October 2022 we have released an updated version of the GAP3 database containing 26999 patients from 25 sites and 15 countries (v4.1.1). We performed an analysis of patients who started on AS between 2000 and 2016. The D’Amico risk classification and baseline characteristics of patients were assessed over time. We assessed treatment free survival (TFS) and metastases free survival (MFS) as clinical endpoints with Kaplan Meier curves RESULTS: Table 1 compares the baseline characteristics over different time periods demonstrating increased numbers of patients enrolled to AS. During the 2000-2004 and 2013-2016 periods the highest proportion of intermediate risk cancers were enrolled. TFS and MFS are demonstrated in Figures 1a,b. During the time periods assessed TFS rates have remained the same however there has been improvement in MFS in more recent times. CONCLUSIONS: There is increasing use of AS for prostate cancer over time and MFS has improved. However, a proportion of intermediate risk cancer patients still develop metastases. Thus, further improvement in selection and monitoring of these patients is required. Source of Funding: The Movember Foundation © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e529 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Paul Doan More articles by this author Lin Zhu More articles by this author Sebastiaan Remmers More articles by this author Daan Nieboer More articles by this author Jozien Helleman More articles by this author Peter Carroll More articles by this author Kyochul Koo More articles by this author Andrew Hayen More articles by this author James Thompson More articles by this author Chris Bangma More articles by this author Expand All Advertisement PDF downloadLoading ...
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