You have accessJournal of UrologyProstate Cancer: Localized (VI)1 Apr 20131353 CHANGE IN CANCER LOCATION AND ACCUMULATION OF CANCER LOCI AND LENGTH PREDICT TREATMENT CHANGE IN PROSPECTIVE ACTIVE SURVEILLANCE COHORT. RESULTS OF THE FINNISH ARM OF THE PRIAS TRIAL Andrew Erickson, Hanna Vasarainen, Utku Lokman, Kanerva Lahdensuo, John Mpindi, Tuomas Mirtti, and Antti Rannikko Andrew EricksonAndrew Erickson Helsinki, Finland More articles by this author , Hanna VasarainenHanna Vasarainen Helsinki, Finland More articles by this author , Utku LokmanUtku Lokman Helsinki, Finland More articles by this author , Kanerva LahdensuoKanerva Lahdensuo Helsinki, Finland More articles by this author , John MpindiJohn Mpindi Helsinki, Finland More articles by this author , Tuomas MirttiTuomas Mirtti Helsinki, Finland More articles by this author , and Antti RannikkoAntti Rannikko Helsinki, Finland More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.03.064AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Currently, the Prostate Cancer Research International: Active Surveillance (PRIAS) study protocol suggests active treatment for patients with more than two positive cores or Gleason score (GS) >6 on a biopsy. However, the protocol neglects shifting cancer locations and cumulative cancer in consecutive biopsies. To our knowledge, there have been no studies analyzing relation between change in biopsy cancer location and patient outcome in prospective AS cohorts. Our objective was to analyze the impact of increasing number of cancer locations, change in cancer location and cumulative cancer length on the treatment discontinuation (TD) of AS. METHODS Clinical and pathology data from patients enrolled in the PRIAS study was prospectively collected (n=228) since 2006. Overall, 69 (30.3%) patients discontinued AS during median follow-up of 3.2 years. 55 (79.7%) discontinued due to PRIAS protocol based criteria, 14 (20.3%) by other criteria. The anxiety related quality of life parameters or s-PSA values did not differ between the patient cohorts. Descriptive statistics were performed and data was analyzed using Mann-Whitney U, chi-square, and binary logistic regression analysis. RESULTS Cumulative number of cancer locations (CNCL) was statistically significantly associated with TD (p<0.001). More than two cancer locations in diagnostic and follow up biopsies also statistically significantly associated with TD in Chi-square test (p<0.001). Similarly, cumulative cancer length (CCL), as well as a shift in cancer location (SCL) significantly predicted TD (p<0.001). In binary logistic regression analysis, only CNCL and CCL were statistically significantly associated with TD among variables studied (age, diagnostic PSA, GS at diagnosis and SCL). CONCLUSIONS Cumulative follow-up biopsy data regarding cancer location and cancer length (volume) may be helpful in predicting treatment discontinuation in an AS cohort. Cancer proportion and accumulative cancer locations could be included to the current regime in order to better select patients for active treatment. The findings in consecutive biopsies should be considered as additive, not separate indicators of clinically relevant disease. Our findings warrant a study to correlate the biopsy cancer locations to RP specimen cancer distribution for further validate the accuracy of PRIAS biopsy regime. Subsequently, the value of repeat biopsy findings to predict PSA velocity and biochemical recurrence after RP needs to be delineated. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e553 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Andrew Erickson Helsinki, Finland More articles by this author Hanna Vasarainen Helsinki, Finland More articles by this author Utku Lokman Helsinki, Finland More articles by this author Kanerva Lahdensuo Helsinki, Finland More articles by this author John Mpindi Helsinki, Finland More articles by this author Tuomas Mirtti Helsinki, Finland More articles by this author Antti Rannikko Helsinki, Finland More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...