You have accessJournal of UrologyProstate Cancer: Localized: Active Surveillance I1 Apr 2016PD03-04 LONG-TERM ONCOLOGIC OUTCOMES OF RADICAL PROSTATECTOMY IN A LARGE COHORT OF PATIENTS ON ACTIVE SURVEILLANCE Ardalan E. Ahmad, Maria Komisarenko, Ruby Grewal, Narhari Timilshina, Robert Hamilton, Girish Kulkarni, Alexandre Zlotta, Neil Fleshner, and Antonio Finelli Ardalan E. AhmadArdalan E. Ahmad More articles by this author , Maria KomisarenkoMaria Komisarenko More articles by this author , Ruby GrewalRuby Grewal More articles by this author , Narhari TimilshinaNarhari Timilshina More articles by this author , Robert HamiltonRobert Hamilton More articles by this author , Girish KulkarniGirish Kulkarni More articles by this author , Alexandre ZlottaAlexandre Zlotta More articles by this author , Neil FleshnerNeil Fleshner More articles by this author , and Antonio FinelliAntonio Finelli More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2092AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Active Surveillance (AS) is widely accepted as the treatment of choice for favorable risk Prostate Cancer (PCa). With the increasing number of men enrolling in AS it is important to understand the treatment outcomes in men who progress on AS and require definitive therapy in the form of radical prostatectomy (RP). We sought to examine the impact of delayed definitive treatment on oncologic outcomes in a cohort of men progressing on active surveillance to RP with a long-term follow up. METHODS We retrospectively reviewed a prospectively maintained database of men on AS from 01/1998-06/2014 at Princess Margaret Cancer Centre (PM). We identified patients on AS who underwent RP as definitive treatment. Biochemical recurrence (BCR) rate was compared to age and prostate specific antigen matched men undergoing immediate radical prostatectomy after a diagnosis of low risk disease who were candidates for active surveillance (control). RESULTS 1246 men met the PM’s AS criteria at diagnosis, 250 patients (20%) progressed on AS to RP. The control group consist of 138 patients. There was no age difference between the 2 groups (P>0.05). At median follow up of 5.7 years (IQR 0.2 to 15.9), 16.7% of patients compared to 5.4% of controls experienced BCR (p=0.005). Delayed RP was associated with a significantly shorter time to BCR compared to control group (median 3 years (0.3-15.1) vs. median 4.7 years, (0.2-13.0)). Clinical stage (T stage) at diagnosis was the only factor predictive of BCR on multivariate analysis. CONCLUSIONS In a non-pathologically matched cohort of patients on AS, patients who progressed to RP had a significantly higher BCR rate compared to patients who underwent immediate RP after diagnosis. While these findings are concerning, comparison of pathological outcomes, cancer specific survival and overall survival between the 2 groups will help us a better understanding the implication of higher BCR rate in delayed RP group. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e57 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Ardalan E. Ahmad More articles by this author Maria Komisarenko More articles by this author Ruby Grewal More articles by this author Narhari Timilshina More articles by this author Robert Hamilton More articles by this author Girish Kulkarni More articles by this author Alexandre Zlotta More articles by this author Neil Fleshner More articles by this author Antonio Finelli More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...