OP3-03 FACTORS ASSOCIATED WITH BIOPSY PROGRESSION ON ACTIVE SURVEILLANCE

Abstract

You have accessJournal of UrologyOutstanding Posters: Oncology1 Apr 2014OP3-03 FACTORS ASSOCIATED WITH BIOPSY PROGRESSION ON ACTIVE SURVEILLANCE Christopher Welty, Janet Cowan, Hao Nguyen, Katsuto Shinohara, Nannette Perez, Kirsten Greene, Maxwell Meng, Matthew Cooperberg, and Peter Carroll Christopher WeltyChristopher Welty More articles by this author , Janet CowanJanet Cowan More articles by this author , Hao NguyenHao Nguyen More articles by this author , Katsuto ShinoharaKatsuto Shinohara More articles by this author , Nannette PerezNannette Perez More articles by this author , Kirsten GreeneKirsten Greene More articles by this author , Maxwell MengMaxwell Meng More articles by this author , Matthew CooperbergMatthew Cooperberg More articles by this author , and Peter CarrollPeter Carroll More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.2324AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Active surveillance (AS) is a treatment strategy for prostate cancer (CaP) involving close monitoring of men diagnosed with low-risk CaP to reduce overtreatment. We report here factors associated with disease progression while on AS in a large, single institution cohort. METHODS We retrospectively reviewed the data of men enrolled in the University of California at San Francisco (UCSF) AS cohort between 1990 and 2012. Strict eligibility criteria were prostate-specific antigen (PSA) <10ng/ml, Stage <cT3, Gleason grade ≤ 6, ≤33% of biopsy cores positive, and ≤ 50% of any single biopsy core positive. Men who did not meet these criteria but still elected AS were followed as well. Surveillance consisted of quarterly PSA testing, reimaging with TRUS at provider discretion, and annual prostate biopsy. Biopsy progression was defined as upgrade to at least Gleason 7 or increase in volume >33% cores. Factors associated with progression while on active surveillance were determined through multivariate Cox proportional hazards regression. RESULTS Of 1,106 men enrolled in AS at UCSF, 764 men have consented to participate in research to date and have been followed on AS for a median of 57 months. Of these, 520 (68%) met strict criteria for AS while 244 (32%) did not. The median number of repeat biopsies was 3 (IQR 2-4). At 5 years after diagnosis, 53 % were progression-free and 40% of patients received local therapy. Overall survival was 94% among those not AS eligible and 99% among those AS eligible at 5 years. There were no CaP-related deaths. In multivariate analysis, PSA density (PSAD), total number of biopsies, and later year of diagnosis were positively associated with the risk of both biopsy progression (HR (95% CI): 1.58 (1.33-1.88); 0.82 (0.72-0.94); 1.17 (1.11-1.25) , respectively) and receiving treatment (HR (95%CI): 1.39 (1.20-1.61); 0.71 (0.64-0.78); 1.20 (1.15-1.25), respectively), all p<0.01. CONCLUSIONS The majority of men who enrolled in this active surveillance cohort remained on AS after a median follow up of 57 months. While higher PSAD was associated with biopsy progression, additional predictive tools would improve selection and counseling of men for AS. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e852 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Christopher Welty More articles by this author Janet Cowan More articles by this author Hao Nguyen More articles by this author Katsuto Shinohara More articles by this author Nannette Perez More articles by this author Kirsten Greene More articles by this author Maxwell Meng More articles by this author Matthew Cooperberg More articles by this author Peter Carroll More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...