Analysis of expanded criteria to select candidates for active surveillance of low-risk prostate cancer.
- Authors
- Jo, Jung Ki; Lee, Han Sol; Lee, Young Ik; Lee, Sang Eun; Hong, Sung Kyu
- Issue Date
- Mar-2015
- Publisher
- MEDKNOW PUBLICATIONS & MEDIA PVT LTD
- Keywords
- prediction; prostate; prostatectomy; prostatic neoplasms; risk
- Citation
- ASIAN JOURNAL OF ANDROLOGY, v.17, no.2, pp.248 - 252
- Indexed
- SCIE
SCOPUS
- Journal Title
- ASIAN JOURNAL OF ANDROLOGY
- Volume
- 17
- Number
- 2
- Start Page
- 248
- End Page
- 252
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/157677
- DOI
- 10.4103/1008-682X.142136
- ISSN
- 1008-682X
- Abstract
- We aimed to analyze the value of each criterion for clinically insignificant prostate cancer (PCa) in the selection of men for active surveillance (AS) of low-risk PCa. We identified 532 men who were treated with radical prostatectomy from 2006 to 2013 who met 4 or all 5 of the criteria for clinically insignificant PCa (clinical stage % T1, prostate specific antigen [PSA] density % 0.15, biopsy Gleason score % 6, number of positive biopsy cores % 2, and no core with > 50% involvement) and analyzed their pathologic and biochemical outcomes. Patients who met all 5 criteria for clinically insignificant PCa were designated as group A (n = 172), and those who met 4 of 5 criteria were designated as group B (n = 360). The association of each criterion with adverse pathologic features was assessed via logistic regression analyses. Comparison of group A and B and also logistic regression analyses showed that PSA density > 0.15 ng ml(1) and high (>= 7) biopsy Gleason score were associated with adverse pathologic features. Higher (> T1c) clinical stage was not associated with any adverse pathologic features. Although % 3 positive cores were not associated with any adverse pathology, >= 4 positive cores were associated with higher risk of extracapsular extension. Among potential candidates for AS, PSA density > 0.15 ng ml(1) and biopsy Gleason score > 6 pose significantly higher risks of harboring more aggressive disease. The eligibility criteria for AS may be expanded to include men with clinical stage T2 tumor and 3 positive cores.
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