You have accessJournal of UrologyProstate Cancer: Localized IV1 Apr 2015PD34-05 5-ALPHA REDUCTASE INHIBITORS IN PATIENTS ON ACTIVE SURVEILLANCE FOR PROSTATE CANCER: IMPACT ON DISEASE PROGRESSION AND CURATIVE INTERVENTION Andre Luis de Castro Abreu, Inderbir Gill, Duke Bahn, Sunao Shoji, Arnaud Marien, Jie Cai, Sameer Chopra, Raed Azhar, Kelvin Wong, Charles Metcalfe, Raj Satkunasivam, and Osamu Ukimura Andre Luis de Castro AbreuAndre Luis de Castro Abreu More articles by this author , Inderbir GillInderbir Gill More articles by this author , Duke BahnDuke Bahn More articles by this author , Sunao ShojiSunao Shoji More articles by this author , Arnaud MarienArnaud Marien More articles by this author , Jie CaiJie Cai More articles by this author , Sameer ChopraSameer Chopra More articles by this author , Raed AzharRaed Azhar More articles by this author , Kelvin WongKelvin Wong More articles by this author , Charles MetcalfeCharles Metcalfe More articles by this author , Raj SatkunasivamRaj Satkunasivam More articles by this author , and Osamu UkimuraOsamu Ukimura More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2241AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To report pathologic progression (PP) and curative intervention (CI) in 361 men on active surveillance (AS) in comparison between with and without use of 5-alpha reductase inhibitors (5-ARI). METHODS Total 361 patients were grouped: with use of 5-ARI (n = 119, 33%) or without use of 5-ARI (No 5-ARI), n=242 (67%). All the patients had at least two years of follow up and the median follow up time was 5.1 years for 5-ARI vs 5.3 years for No 5-ARI (p=0.6). The AS protocol included PSA (6 monthly), multi-parametric transrectal ultrasound (TRUS) annually, and surveillance biopsy (2-3 yearly, or as indicated). PP was defined as upgrade on Gleason score, increase in cancer core length (>4mm) or percent (>25%), or clinical progression on the follow up. CI was defined as discontinuing AS to undergo any kind of curative or hormonal therapy. Clinical variables were compared between the two groups. Kaplan-Meier method was conducted to estimate survivals for PP and CI, and multivariable Cox regression for predictors of PP. RESULTS At the entry, the two groups were similar: age (63 vs. 61yrs, p=0.1), PSA (4.8 vs. 4.8ng/ml, p=0.5), prostate volume on TRUS (41cc vs. 35cc, p=0.1), clinical stage T1c/T2a (85%/13% vs. 90%/9%, p=0.06), biopsy Gleason score (6/3+4/4+3 = 88%/10%/2% vs. 87%/11%/2%, p=0.9), biopsy cancer core length (1.5mm vs. 1mm, p=0.37) and percent (10% vs. 8.5%, p=0.2) of index cancer, and number of positive cores (1 vs. 1, p=0.1), respectively for 5-ARI vs No 5-ARI groups. Predictors of PP were: not taking 5-ARI (p=0.017), entry PSA > 4ng/ml (p=0.009) and Gleason pattern 4 in biopsy (p<0.001). In regression analyses, 5-ARI-group had lowered the risk of PP by 41%. Estimated probability of PP-free survival (Fig 1) and CI-free survival (Fig 2) are shown: CONCLUSIONS The use of 5-ARI for selected patients on AS delayed PCa progression and curative intervention. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e756 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Andre Luis de Castro Abreu More articles by this author Inderbir Gill More articles by this author Duke Bahn More articles by this author Sunao Shoji More articles by this author Arnaud Marien More articles by this author Jie Cai More articles by this author Sameer Chopra More articles by this author Raed Azhar More articles by this author Kelvin Wong More articles by this author Charles Metcalfe More articles by this author Raj Satkunasivam More articles by this author Osamu Ukimura More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...