MP42-20 PATHOLOGIC OUTCOMES OF CANDIDATES FOR ACTIVE SURVEILLANCE UNDERGOING RADICAL PROSTATECTOMY: RESULTS FROM A CONTEMPORARY TURKISH PATIENT COHORT

Abstract

You have accessJournal of UrologyProstate Cancer: Localized I1 Apr 2015MP42-20 PATHOLOGIC OUTCOMES OF CANDIDATES FOR ACTIVE SURVEILLANCE UNDERGOING RADICAL PROSTATECTOMY: RESULTS FROM A CONTEMPORARY TURKISH PATIENT COHORT Ilker Tinay, Guven Aslan, Ali Riza Kural, Haluk Ozen, Bulent Akdogan, Asif Yildirim, Ozdal Dillioglugil, Tarik Esen, Ferruh Zorlu, and Levent Turkeri Ilker TinayIlker Tinay More articles by this author , Guven AslanGuven Aslan More articles by this author , Ali Riza KuralAli Riza Kural More articles by this author , Haluk OzenHaluk Ozen More articles by this author , Bulent AkdoganBulent Akdogan More articles by this author , Asif YildirimAsif Yildirim More articles by this author , Ozdal DillioglugilOzdal Dillioglugil More articles by this author , Tarik EsenTarik Esen More articles by this author , Ferruh ZorluFerruh Zorlu More articles by this author , and Levent TurkeriLevent Turkeri More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1605AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To evaluate the pathological outcomes of Turkish men meeting criteria for AS, who elected immediate radical prostatectomy (RP) to assess the risk of under-grading and under-staging in candidates for AS. METHODS Criteria for potential AS was defined as: clinical stage T2 or lower, PSA 15 ng/mL or lower, Gleason sum 6 or lower(without 4 as primary or secondary), total biopsy cores 8 or more, 33.3% or lower tumor positive cores on biopsy pathology and with at least 2 years follow-up after RP. The primary outcomes were pathological up-staging, defined as the occurrence of extracapsular extension (T3a) or seminal vesicle involvement (T3b), and pathological up-grading, defined as a Gleason sum 7 or higher. Regarding the study design, all data were submitted online by the investigator of participating instutition to the database, which is created specifically for this study within the “Association of Urooncology, Turkey”. RESULTS Of the 1,212 patients, 981 met study inclusion criteria. Mean PSA level was 6.89 (0.51-15) ng/mL and mean biopsy core number was 12 (8-47). Mean tumor positive cores on final biopsy pathology were 1.95 (1-6) cores [16.6%(2.1-33.3%)]. The RP technique was open, laparoscopic and robotic surgery in 744, 24 and 134, respectively. A total of 368 men (37.5%) underwent pelvic lymph node dissection and only 1 patient (0.2%) had tumor invasion at the final RP pathology. Overall 30.6 % of the men experienced a Gleason sum upgrade and 11.5% had pathological up-staging (figure). A total of 24 men (2.7%) died during follow-up from other causes. A total of 10 patients (1%) underwent radiotherapy with hormonal treatment and had a higher mean PSA level (7.85 vs. 6.89) with higher mean tumor positive core percentage (20.2% vs. 16.6%). A total of 22 patients (2.4%) received only adjuvant radiotherapy and had a higher mean PSA level (7.3 vs. 6.89) but lower mean tumor positive core percentage (15.6% vs. 16.6%). In the remaining 863 patients, who did not received any adjuvant treatment, 26 (3%) experienced PSA failure at a mean time of 35 months (12-88) after the surgery. CONCLUSIONS In conclusion, up-grading and up-staging at RP is common among Turkish men with low-risk PCa, who are candidates for AS. Most Turkish men with low-risk PCa treated with RP experience long-term PSA control. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e517 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ilker Tinay More articles by this author Guven Aslan More articles by this author Ali Riza Kural More articles by this author Haluk Ozen More articles by this author Bulent Akdogan More articles by this author Asif Yildirim More articles by this author Ozdal Dillioglugil More articles by this author Tarik Esen More articles by this author Ferruh Zorlu More articles by this author Levent Turkeri More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...