580 IS SCREEN-DETECTED PROSTATE CANCER IN HIGH RISK FAMILIES ELIGIBLE FOR ACTIVE SURVEILLANCE?

53+RZHYHUWKHDFFXUDF\RIWKHPXOWLYDULDEOHORJLVWLFUHJUHVVLRQPRGHOSUHGLFWLQJ LSVLODWHUDOSURVWDWHFDQFHUZDVRQO\ Conclusions: ,Q SDWLHQWV ZLWK XQLODWHUDO ORZULVN SURVWDWH FDQFHU DW ELRSV\ OHVV WKDQ  VKRZHG LSVLODWHUDO SURVWDWH FDQFHU DW 53 7KH QXPEHU RI FRUHV DQG WKH QXPEHU RI SRVLWLYH FRUHV UHSUHVHQWHG LQGHSHQGHQW SUHGLFWRUV RI LSVLODWHUDO SURVWDWHFDQFHU+RZHYHUWKHDFFXUDF\RIWKHPXOWLYDULDEOHPRGHOWHVWHGZDVORZ  WKXVPDNLQJSUHGLFWLRQRILSVLODWHUDOSURVWDWHFDQFHUH[WUHPHO\XQDFFXUDWH 7KHVHUHVXOWVQHHGWREHWDNHQLQWRDFFRXQWLQWKRVHFDVHVZKHUHIRFDOWKHUDS\LV FRQVLGHUHGDVDWUHDWPHQWRSWLRQIRUSURVWDWHFDQFHU

578

HISTOPATHOLOGIC AND FUNCTIONAL OUTCOMES FOR ACTIVE SURVEILLANCE CANDIDATES WHO OPT FOR PROSTATECTOMY

%UDMWERUG-6/DYHU\+-1DEL]DGD3DFH)6HQDUDWQH66DPDGL'% Mount Sinai Medical Center, Dept. of Urology, New York, United States of America Introduction & Objectives: $FWLYH VXUYHLOODQFH $6  LV JURZLQJ LQ SRSXODULW\ DV DWUHDWPHQWRSWLRQIRUPHQZLWKORZULVNORFDOL]HGSURVWDWHFDQFHU:HHYDOXDWHG WKHᚏQDOKLVWRSDWKRORJLFRXWFRPHVRISDWLHQWVZLWKSUHRSHUDWLYHO\ORZULVNFDQFHU DQG WKRVH ZKR TXDOLᚏHG IRU $6 EXW RSWHG IRU URERWLFDVVLVWHG ODSDURVFRSLF SURVWDWHFWRP\5$/3  Material & Methods: $Q LQVWLWXWLRQDO GDWDEDVH ZDV UHYLHZHG IRU  5$/3 SHUIRUPHGE\DVLQJOHVXUJHRQ'%6 3DWLHQWVZLWKಯORZSUHRSHUDWLYHULVNGLVHDVHರ ZHUHGHᚏQHGDV36$QJP/FOLQLFDOVWDJHื7DDQGELRSV\*OHDVRQVFRUHื Q  3DWLHQWVZKRTXDOLᚏHGIRUDFWLYHVXUYHLOODQFHZHUHLGHQWLᚏHGDVIXOᚏOOLQJ WKHFULWHULDIRUಯORZULVNGLVHDVHರEXWDGGLWLRQDOO\KDGSRVLWLYHFRUHVDQG WXPRXUYROXPHLQDVLQJOHFRUHQ  &RQWLQHQFHZDVGHᚏQHGDVWKHXVHRI]HUR RURQHVHFXULW\SDGGDLO\3RWHQF\ZDVGHᚏQHGDVD6+,0ุLQSDWLHQWVZKR ZHUH SUHRSHUDWLYHO\ SRWHQW 6+,0 ุ   3RVLWLYH VXUJLFDO PDUJLQV ZHUH GHᚏQHG DV WXPRXU SUHVHQW DW WKH LQNHG PDUJLQ %LRFKHPLFDO UHFXUUHQFH ZDV GHᚏQHG DV 36$!QJPO Results: 2Qᚏ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ᚏFDQW SUHGLFWRUVRIWXPRXUXSJUDGLQJRQᚏQDOSDWKRORJ\S  Conclusions: 3DWLHQWV ZLWK ORZULVN SURVWDWH FDQFHU DQG HVSHFLDOO\ WKRVH ZKR ZRXOGTXDOLI\IRU$6KDYHYHU\IDYRXUDEOHRSWLRQVDYDLODEOHWRWKHP7KRVHZKR GHVLUHFXUDWLYHWKHUDS\KDYHDKLJKOLNHOLKRRGRIDFKLHYLQJH[FHOOHQWIXQFWLRQDODQG RQFRORJLFRXWFRPHVIROORZLQJ5$/37KRVHZKRHOHFW$6FDQEHUHDVVXUHGWKDW WKH PDMRULW\ RI $6 FDQGLGDWHV KDG IDYRXUDEOH WXPRXU FKDUDFWHULVWLFV DW WKH WLPH RI SURVWDWHFWRP\ DV RQO\  ZHUH XSVWDJHG $OWKRXJK ZH IRXQG D  UDWH RI XSJUDGLQJWKHYDVWPDMRULW\ZHUHXSJUDGHGWRWKHPRUHEHQLJQ 2QO\ ZHUHXSJUDGHGWR DQGQRQHWR*OHDVRQRUKLJKHU7KLVFRKRUWRISDWLHQWV ZLOOOLNHO\GRZHOOUHJDUGOHVVRIZKHWKHUWKH\FKRRVH$6RUVXUJLFDOH[WLUSDWLRQ

579

CONCORDANCE BETWEEN BIOPSY AND PROSTATECTOMY SPECIMENS REGARDING GLEASON SUM 







9RONRYD0, (UPLORYD9' 0DWYHHY9% 0LWLQ$$ 1 N.N. Blokhin Cancer Center, Dept. of Urology, Moscow, Russia, 2N.N. Blokhin Cancer Center, Dept. of Pathology, Moscow, Russia Introduction & Objectives: 7R HYDOXDWH FRQFRUGDQFH EHWZHHQ ELRSV\ DQG SURVWDWHFWRP\VSHFLPHQVUHJDUGLQJ*OHDVRQVXPLQSDWLHQWVZLWKSURVWDWHFDQFHU S710 Material & Methods: 7KHFDVHUHFRUGVRISDWLHQWVZLWKSURVWDWHFDQFHUS7 10 ZKR XQGHUZHQW UHWURSXELF UDGLFDO SURVWDWHFWRP\ IURP  WR  ZHUHUHYLHZHG0HGLDQDJHZDVs \HDUV0HGLDQ36$OHYHOEHIRUH VXUJHU\ ZDV s   QJPO %LRSV\ VSHFLPHQV ZHUH REWDLQHG ZLWK XOWUDVRXQGJXLGHGFRUHELRSVLHVPHGLDQFRUHQXPEHUs $OOSDWLHQWV XQGHUZHQW UHWURSXELF UDGLFDO SURVWDWHFWRP\ $OO VSHFLPHQV ZHUH LQYHVWLJDWHG E\ WKHRQO\SDWKRORJLVW7KH*OHDVRQVFRUHGHWHUPLQHGZLWKXOWUDVRXQGJXLGHGFRUH ELRSVLHVZDVFRPSDUHGZLWKWKH*OHDVRQVFRUHZLWKLQWKHVXUJLFDOVSHFLPHQV Results: $OO SDWLHQWV ZHUH GLDJQRVHG ZLWK SURVWDWH DGHQRFDUFLQRPD 0HGLDQ ELRSV\ *OHDVRQ VXP ZDV s  s  s *OHDVRQ VXP ದ   *OHDVRQVXPุದ )LQDOSDWKRORJ\UHYHDOHGFDWHJRU\͗7!̹ LQ FDWHJRU\͗1LQ SDWLHQWV0HGLDQSURVWDWHFWRP\*OHDVRQ VXPZDVss s*OHDVRQVXPದ *OHDVRQ VXPุದ 'LVFRUGDQW*OHDVRQVXPEHWZHHQSURVWDWHELRSV\DQGUDGLFDO SURVWDWHFWRP\VSHFLPHQV*OHDVRQVXPRUุ ZDVGHWHUPLQHGLQ 

Eur Urol Suppl 2010;9(2):196

RISDWLHQWV$GRZQJUDGLQJLQVXUJLFDOVSHFLPHQVRFFXUUHGLQ RI DQXSJUDGLQJದLQ RIFDVHV%LRSV\*OHDVRQVXPVHQVLWLYLW\LQ WKHSDWKRORJLFDOJUDGLQJHVWLPDWLRQ*OHDVRQVXPRUุ ZDVVSHFLᚏFLW\ ದGLDJQRVWLFHᚑFDF\ದSRVLWLYHSUHGLFWLYHYDOXHದQHJDWLYH SUHGLFWLYH YDOXH ದ  DUHD XQGHU UHFHLYHU RSHUDWLQJ FKDUDFWHULVWLF FXUYH ದ s&,S  Conclusions: 7KHDELOLW\RIXOWUDVRXQGJXLGHGELRSV\WRHVWLPDWHWKHSDWKRORJLFDO JUDGLQJLVVDWLVIDFWRU\&RQFRUGDQFHRIELRSV\DQGSURVWDWHFWRP\*OHDVRQVXPLV FRQᚏUPHGLQRIFDVHV

580

IS SCREEN-DETECTED PROSTATE CANCER IN HIGH RISK FAMILIES ELIGIBLE FOR ACTIVE SURVEILLANCE?

9DOHUL$3DSLQ*0RLQHDX03$]]RX]L$5&RUPLHU/%DVFKHW) &XVVHQRW,/ಬKHU-'RXFHW/-RXOLQ9'HUXHOOH&0DQJLQ3 &XVVHQRW2)RXUQLHU* 1 Centre Hospitalier Universitaire de Brest, Dept. of Urology, Brest, France, 2 Centre Hospitalier Universitaire de Brest, Dept. of Nuclear Medicine, Brest, France, 3Centre Hospitalier Universitaire D’Angers, Dept. of Urology, Angers, France, 4Centre Hospitalier Universitaire de Dijon, Dept. of Urology, Dijon, France, 5Centre de Recherche pour les Pathologies Prostatiques, Dept. of CeRePP, Paris, France, 6Centre Hospitalier Universitaire de Brest, Dept. of Pathology, Brest, France, 7Centre Hospitalier Universitaire, Hospital Tenon, Dept. of Urology, Paris, France Introduction & Objectives: $W SUHVHQW LQVLJQLᚏFDQW SURVWDWH FDQFHU &D3  LV WKRXJKW WR EH GLDJQRVHG LQ DV PXFK DV  RI FDVHV DFFRUGLQJ WR UDQGRPLVHG PDVVVFUHHQLQJVWXGLHV7KHDLPRIWKLVVWXG\ZDVWRDVVHVVLIWKLVKLJKUDWHLVDOVR REVHUYHGLQKLJKULVNIDPLOLHV Material & Methods: 6LQFHZHREWDLQHGDVHUXP36$WHVWLQJ\HDUO\LQD \HDUVFUHHQLQJSURJUDPLQPHQEURWKHUVRUVRQV\RRI&D3SDWLHQWV 3URVWDWLF ELRSVLHV ZHUH SHUIRUPHG IRU 36$ !QJPO XQWLO   DQG IRU 36$ !QJPO WKHUHDIWHU $ V\VWHPDWLF JHQHDORJLFDO DQDO\VLV SUHYLRXVO\ SHUIRUPHG DOORZHG WR GHᚏQH WKH IDPLOLDO &D3 VWDWXV LQ RUGHU WR FODVVLI\ WKH VFUHHQHG PHQ LQWRKHUHGLWDU\VWDWXV&D3 IDPLOLDOZLWKRXWREYLRXVKHUHGLWDU\SDWWHUQ &D3   DQG VSRUDGLF  &D3  &D3 SRWHQWLDOO\ HOLJLEOH IRU DFWLYH VXUYHLOODQFH$6 ZHUHUHWURVSHFWLYHO\GHᚏQHGDVIROORZLQJ36$QJPOFOLQLFDO VWDJH7E*OHDVRQVFRUHSRVLWLYHFRUHVOHQJWKRI&D3FRUHPP Results:  &D3 ZHUH GLDJQRVHG   LQ PHQ DJHG  DQG   LQ ROGHU PHQ  PHG DJH \ 7  PHG 36$ QJPO *OHDVRQVFRUH 2IWKHGLDJQRVHG&D3ZHUHHOLJLEOHIRUWKHVWXG\ DFFRUGLQJWRDYDLODEOHVWXGLHGSDUDPHWHUV2QO\ IXOᚏOOHGGLDJQRVLV FULWHULD IRU $6 DV SUHYLRXVO\ GHᚏQHG 7DNLQJ LQWR DFFRXQW SDWKRORJLFDO VWDJH IRU RSHUDWHG SDWLHQWV RU WKH SUHYLRXV GLDJQRVLV FULWHULD IRU QRQ RSHUDWHG SDWLHQWV  &D3ZHUHHOLJOHIRUDQDO\VLVDQGRQO\&D3 PD\EHFRQVLGHUHGDV LQVLJQLᚏFDQW 1RQH RI WKH  GLDJQRVHG &D3 LQ \RXQJ DJHG  SDWLHQWV ZHUH LQVLJQLᚏFDQW Conclusions: 7KRVHUHVXOWVVXJJHVWWKDWVFUHHQGHWHFWHG&D3LQKLJKULVNIDPLOLHV DUHOHVVIUHTXHQWO\LQVLJQLᚏFDQW&D3DVFRPSDUHGWRWKHJHQHUDOSRSXODWLRQDQG UHTXLUHPRUHIUHTXHQWO\FXUDWLYHWUHDWPHQWDWGLDJQRVLV

581

INDEPENDENT RISK FACTORS FOR GLEASON SCORE DOWNGRADING IN PATIENTS WITH EXTENDED PROSTATE BIOPSY

:DOGHUW0.ODWWH75HP]L00DUEHUJHU0 Medical University of Vienna, Dept. of Urology, Vienna, Austria Introduction & Objectives: 'RZQJUDGLQJRIELRSV\*OHDVRQ6FRUH*6 LQUDGLFDO SURVWDWHFWRP\ VSHFLPHQ LV D SRRUO\ GHVFULEHG SKHQRPHQRQ LQ SDWLHQWV ZLWK H[WHQGHGSURVWDWHELRSV\SURWRFROV7KLVLVHVSHFLDOO\LPSRUWDQWZKHQRSWLQJIRU PLQLPDOLQYDVLYHRUIRFDOWKHUDSLHV:HHYDOXDWHGLQGHSHQGHQWULVNIDFWRUVIRU*6 GRZQJUDGLQJ Material & Methods: %HWZHHQDQGSDWLHQWVXQGHUZHQWH[WHQGHG SURVWDWH ELRSV\ DQG UDGLFDO SURVWDWHFWRP\ DW RXU LQVWLWXWLRQ 0XOWLYDULDWH ORJLVWLF UHJUHVVLRQ DQDO\VLV ZDV SHUIRUPHG WR LGHQWLI\ LQGHSHQGHQW ULVN IDFWRUV IRU *6 GRZQJUDGLQJ3URVWDWHYROXPHDQGSURVWDWHVSHFLᚏFDQWLJHQ36$ ZHUHDVVHVVHG DVFRQWLQXRXVYDULDEOHV Results: 0HDQSDWLHQWDJHZDV\HDUVPHDQ36$QJPODQG PHDQSURVWDWHYROXPHPO'58ZDVSRVLWLYHLQ0HGLDQQXPEHURI FRUHVWDNHQZDV5DQJH 'RZQJUDGLQJZDVIRXQGLQRISDWLHQWV RI*6RI*6RI*6RI*6DQGRI*6FDQFHUV ZHUH GRZQJUDGHG S  2Q PXOWLYDULDWH DQDO\VLV LQGHSHQGHQW SUHGLFWRUV IRU GRZQJUDGLQJ ZHUH ODUJH SURVWDWH YROXPH 25  S  SHUFHQWDJH RI SRVLWLYHFRUHV25S  DQGKLJKELRSV\*625S 7KH DUHDXQGHUWKH52&FXUYHIRUWKLVPRGHOZDV'RZQJUDGHGFDQFHUVKDGD ORZHUULVNIRUSRVLWLYHVXUJLFDOPDUJLQVS  Conclusions: /DUJHSURVWDWHYROXPHRISRVLWLYHFRUHVDQGKLJKELRSV\*6ZHUH LQGHSHQGHQWSUHGLFWRUVIRUGRZQJUDGLQJ6LQFHWKHUHLVRQO\DORZSUREDELOLW\LQ*6  FDQFHUV IRU GRZQJUDGLQJ WR LQVLJQLᚏFDQW FDQFHU DFWLYH VXUYHLOODQFH RU PLQLPDO LQYDVLYHWKHUDSLHVDUHQRWMXVWLᚏHGDQGGHᚏQLWLYHWKHUDS\VKRXOGEHDSSOLHG