MP62-10 OUTCOME IN MEN CONTINUING ACTIVE SURVEILLANCE DESPITE PROTOCOL ADVICE TO DISCONTINUE

Abstract

You have accessJournal of UrologyProstate Cancer: Localized VII1 Apr 2014MP62-10 OUTCOME IN MEN CONTINUING ACTIVE SURVEILLANCE DESPITE PROTOCOL ADVICE TO DISCONTINUE Leonard Bokhorst, Jolanda Salman, Lionne Venderbos, Antti Rannikko, Riccardo Valdagni, Tom Pickles, Yoshiyuki Kakehi, Chris Bangma, and Monique Roobol Leonard BokhorstLeonard Bokhorst More articles by this author , Jolanda SalmanJolanda Salman More articles by this author , Lionne VenderbosLionne Venderbos More articles by this author , Antti RannikkoAntti Rannikko More articles by this author , Riccardo ValdagniRiccardo Valdagni More articles by this author , Tom PicklesTom Pickles More articles by this author , Yoshiyuki KakehiYoshiyuki Kakehi More articles by this author , Chris BangmaChris Bangma More articles by this author , and Monique RoobolMonique Roobol More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1967AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Men with prostate cancer (PCa) on active surveillance (AS) are advised to switch to definitive treatment if progression occurs. However, some men continue AS despite protocol advice to switch to definitive treatment. OBJECTIVE To determine outcomes in men continuing AS despite protocol advice to switch to definitive treatment. METHODS 3701 men with low-risk PCa were included in the ongoing prospective Prostate cancer Research International: Active Surveillance (PRIAS) study until October 2013. Men were regularly examined using PSA, DRE, and repeat biopsy (figure 1) and advised to switch to definitive treatment if progression occurred (clinical stage >=T3, Gleason score (GS) >3+3, >2 cores with PCa at repeat biopsy, PSA-doubling time (PSADT) <=3 yr (only after 5 PSA values were available)). Men were classified as continuing AS if at least 1 visit was available after any protocol based reason to discontinue. Outcome was GS >=7 at last available repeat biopsy after a protocol based reason to discontinue. RESULTS A total of 1259 men (34%) had a protocol recommendation to discontinue AS at a median FU of 1.1 yr (range 0.3 – 7.0 yr). During follow-up 9 men had clinical stage >=T3 of which 1 continued AS (11.1%), 256 had GS >3+3 at any repeat biopsy of which 33 continued AS (12.9%), 553 had >2 cores with PCa at any repeat biopsy of which 112 continued AS (20.3%), and 756 had PSA-DT <=3 yr of which 522 continued AS (69.0%). In table 1 the GS at the last available repeat biopsy after continuation of AS is shown. Men with PSADT <=3 yr or >2 cores positive with PCa more often had a GS >=7 at repeat biopsy (21.4% and 20.0%, respectively) versus men without protocol advice to discontinue (11.0%, p-value 0.005 and 0.096, respectively). Especially a GS >=8 was more common in men who continued after protocol advice (table 1). CONCLUSIONS Some men do not discontinue AS despite protocol advice to do so. Especially a short PSADT is often ignored. Although these men more often have a high GS at repeat biopsy, a favorable outcome is still seen in the majority of them. This questions if PSADT should be a trigger for definitive treatment. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e720-e721 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Leonard Bokhorst More articles by this author Jolanda Salman More articles by this author Lionne Venderbos More articles by this author Antti Rannikko More articles by this author Riccardo Valdagni More articles by this author Tom Pickles More articles by this author Yoshiyuki Kakehi More articles by this author Chris Bangma More articles by this author Monique Roobol More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...