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Active surveillance in patients with localized prostate cancer – 10 years experience
EAU16th Central European Meeting, 7-8 October 2016, Vienna, Austria
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Active surveillance in patients with localized prostate cancer – 10 years experience Eur Urol Suppl 2016; 15(11);e1410
Belej K.1, Kaplan O.1, Kohler O.1, Chmelik F.2, Horeni E.2 1
Na Homolce Hospital, Urology-Dept. of Surgery, Prague 5, Czech Republic, 2Military University Hospital, Dept. of Urology, Prague 6, Czech Republic INTRODUCTION & OBJECTIVES: Active surveillance (AS) in patients with localized prostate cancer is an integral part of the treatment of the affected males. Its goal is to save the patients from local treatment adverse effects and to achieve correct timing for curative treatment when needed. Abstract summarizes ten years experience with AS in the robotic centre. MATERIAL & METHODS: Thirty six patients with at least five years follow-up and very low/low risk prostate cancer were enrolled into AS programme starting in the year 2006. Inclusion and exlusion criteria from the largest European AS study (PRIAS) were used in the prospective study and the modified follow-up schedule was also adopted from the PRIAS. Collected data included patients´ age, prostatic specific antigen levels, cancer staging, Gleason score (GS), number of positive/total cores numbers, digital rectal examination results, prostate during follow-up and histopathological records from rebiopsies and postoperative specimens. RESULTS: Twenty eight out of 36 patients were eligible for the evaluation in our AS group. Average age was 63,7 years (interval 58−72 years) with medium follow-up of 6,8 years (5,2−9,6 years). Six patients were shifted from the AS programme to the active local treatment based on psychological factors (3 males with anxiety), histopathological findings in rebiopsies (2 patients) and clinical progression (1 patient). None of the patients were indicated for the active therapy based on biochemical progression calculated with PSA doubling time (mean 6,2 years; interval 3,6−18 years). Robotic assisted radical prostatectomy was performed in all of them resulted in pT2 in four and pT3 in two patients, respectively. No cancer was found on protocol rebiopsy in nine males, different positive core(s) location was observed in ten patients and progression in rebiopsy GS occurred in eight patients during follow-up in untreated group. CONCLUSIONS: AS remains an investigational approach for the patients with localized prostate cancer and its certain role is still unclear. Based on current knowledge it is safe and useful way to manage selected and motivated patients with possible shift to the active treatment based on available clinical parameters.
Eur Urol Suppl 2016; 15(11);e1410 Powered by TCPDF (www.tcpdf.org)
47
Active surveillance in patients with localized prostate cancer – 10 years experience Eur Urol Suppl 2016; 15(11);e1410
Belej K.1, Kaplan O.1, Kohler O.1, Chmelik F.2, Horeni E.2 1
Na Homolce Hospital, Urology-Dept. of Surgery, Prague 5, Czech Republic, 2Military University Hospital, Dept. of Urology, Prague 6, Czech Republic INTRODUCTION & OBJECTIVES: Active surveillance (AS) in patients with localized prostate cancer is an integral part of the treatment of the affected males. Its goal is to save the patients from local treatment adverse effects and to achieve correct timing for curative treatment when needed. Abstract summarizes ten years experience with AS in the robotic centre. MATERIAL & METHODS: Thirty six patients with at least five years follow-up and very low/low risk prostate cancer were enrolled into AS programme starting in the year 2006. Inclusion and exlusion criteria from the largest European AS study (PRIAS) were used in the prospective study and the modified follow-up schedule was also adopted from the PRIAS. Collected data included patients´ age, prostatic specific antigen levels, cancer staging, Gleason score (GS), number of positive/total cores numbers, digital rectal examination results, prostate during follow-up and histopathological records from rebiopsies and postoperative specimens. RESULTS: Twenty eight out of 36 patients were eligible for the evaluation in our AS group. Average age was 63,7 years (interval 58−72 years) with medium follow-up of 6,8 years (5,2−9,6 years). Six patients were shifted from the AS programme to the active local treatment based on psychological factors (3 males with anxiety), histopathological findings in rebiopsies (2 patients) and clinical progression (1 patient). None of the patients were indicated for the active therapy based on biochemical progression calculated with PSA doubling time (mean 6,2 years; interval 3,6−18 years). Robotic assisted radical prostatectomy was performed in all of them resulted in pT2 in four and pT3 in two patients, respectively. No cancer was found on protocol rebiopsy in nine males, different positive core(s) location was observed in ten patients and progression in rebiopsy GS occurred in eight patients during follow-up in untreated group. CONCLUSIONS: AS remains an investigational approach for the patients with localized prostate cancer and its certain role is still unclear. Based on current knowledge it is safe and useful way to manage selected and motivated patients with possible shift to the active treatment based on available clinical parameters.
Eur Urol Suppl 2016; 15(11);e1410 Powered by TCPDF (www.tcpdf.org)