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MP42-20 PATHOLOGIC OUTCOMES OF CANDIDATES FOR ACTIVE SURVEILLANCE UNDERGOING RADICAL PROSTATECTOMY: RESULTS FROM A CONTEMPORARY TURKISH PATIENT COHORT
Vol. 193, No. 4S, Supplement, Sunday, May 17, 2015
outcomes. Work in this area would benefit from user-centered design of decision aids that promote shared decision making.
THE JOURNAL OF UROLOGYâ
The primary outcomes were pathological up-staging, defined as the occurrence of extracapsular extension (T3a) or seminal vesicle involvement (T3b), and pathological up-grading, defined as a Gleason sum 7 or higher. Regarding the study design, all data were submitted online by the investigator of participating instutition to the database, which is created specifically for this study within the “Association of Urooncology, Turkey”. RESULTS: Of the 1,212 patients, 981 met study inclusion criteria. Mean PSA level was 6.89 (0.51-15) ng/mL and mean biopsy core number was 12 (8-47). Mean tumor positive cores on final biopsy pathology were 1.95 (1-6) cores [16.6%(2.1-33.3%)]. The RP technique was open, laparoscopic and robotic surgery in 744, 24 and 134, respectively. A total of 368 men (37.5%) underwent pelvic lymph node dissection and only 1 patient (0.2%) had tumor invasion at the final RP pathology. Overall 30.6 % of the men experienced a Gleason sum upgrade and 11.5% had pathological up-staging (figure). A total of 24 men (2.7%) died during follow-up from other causes. A total of 10 patients (1%) underwent radiotherapy with hormonal treatment and had a higher mean PSA level (7.85 vs. 6.89) with higher mean tumor positive core percentage (20.2% vs. 16.6%). A total of 22 patients (2.4%) received only adjuvant radiotherapy and had a higher mean PSA level (7.3 vs. 6.89) but lower mean tumor positive core percentage (15.6% vs. 16.6%). In the remaining 863 patients, who did not received any adjuvant treatment, 26 (3%) experienced PSA failure at a mean time of 35 months (12-88) after the surgery. CONCLUSIONS: In conclusion, up-grading and up-staging at RP is common among Turkish men with low-risk PCa, who are candidates for AS. Most Turkish men with low-risk PCa treated with RP experience long-term PSA control.
Source of Funding: This research was conducted by the Clinical Urology and Epidemiology (CLUE) Working Group supported by the Academy of Finland (#276046), Jane and Aatos Erkko Foundation, and Sigrid Juse’lius Foundation. Dr. Agoritsas was financially supported by Fellowship for Prospective Researchers Grant No. P3SMP3_155290 from the Swiss National Science Foundation. The sponsors had no role in the analysis and interpretation of the data or the manuscript preparation, review, or approval.
MP42-20 PATHOLOGIC OUTCOMES OF CANDIDATES FOR ACTIVE SURVEILLANCE UNDERGOING RADICAL PROSTATECTOMY: RESULTS FROM A CONTEMPORARY TURKISH PATIENT COHORT Ilker Tinay*, Istanbul, Turkey; Guven Aslan, Izmir, Turkey; Ali Riza Kural, Istanbul, Turkey; Haluk Ozen, Turkey; Bulent Akdogan, Ankara, Turkey; Asif Yildirim, Istanbul, Turkey; Ozdal Dillioglugil, Kocaeli, Turkey; Tarik Esen, Istanbul, Turkey; Ferruh Zorlu, Izmir, Turkey; Levent Turkeri, Istanbul, Turkey INTRODUCTION AND OBJECTIVES: To evaluate the pathological outcomes of Turkish men meeting criteria for AS, who elected immediate radical prostatectomy (RP) to assess the risk of undergrading and under-staging in candidates for AS. METHODS: Criteria for potential AS was defined as: clinical stage T2 or lower, PSA 15 ng/mL or lower, Gleason sum 6 or lower(without 4 as primary or secondary), total biopsy cores 8 or more, 33.3% or lower tumor positive cores on biopsy pathology and with at least 2 years follow-up after RP.
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Source of Funding: None
outcomes. Work in this area would benefit from user-centered design of decision aids that promote shared decision making.
THE JOURNAL OF UROLOGYâ
The primary outcomes were pathological up-staging, defined as the occurrence of extracapsular extension (T3a) or seminal vesicle involvement (T3b), and pathological up-grading, defined as a Gleason sum 7 or higher. Regarding the study design, all data were submitted online by the investigator of participating instutition to the database, which is created specifically for this study within the “Association of Urooncology, Turkey”. RESULTS: Of the 1,212 patients, 981 met study inclusion criteria. Mean PSA level was 6.89 (0.51-15) ng/mL and mean biopsy core number was 12 (8-47). Mean tumor positive cores on final biopsy pathology were 1.95 (1-6) cores [16.6%(2.1-33.3%)]. The RP technique was open, laparoscopic and robotic surgery in 744, 24 and 134, respectively. A total of 368 men (37.5%) underwent pelvic lymph node dissection and only 1 patient (0.2%) had tumor invasion at the final RP pathology. Overall 30.6 % of the men experienced a Gleason sum upgrade and 11.5% had pathological up-staging (figure). A total of 24 men (2.7%) died during follow-up from other causes. A total of 10 patients (1%) underwent radiotherapy with hormonal treatment and had a higher mean PSA level (7.85 vs. 6.89) with higher mean tumor positive core percentage (20.2% vs. 16.6%). A total of 22 patients (2.4%) received only adjuvant radiotherapy and had a higher mean PSA level (7.3 vs. 6.89) but lower mean tumor positive core percentage (15.6% vs. 16.6%). In the remaining 863 patients, who did not received any adjuvant treatment, 26 (3%) experienced PSA failure at a mean time of 35 months (12-88) after the surgery. CONCLUSIONS: In conclusion, up-grading and up-staging at RP is common among Turkish men with low-risk PCa, who are candidates for AS. Most Turkish men with low-risk PCa treated with RP experience long-term PSA control.
Source of Funding: This research was conducted by the Clinical Urology and Epidemiology (CLUE) Working Group supported by the Academy of Finland (#276046), Jane and Aatos Erkko Foundation, and Sigrid Juse’lius Foundation. Dr. Agoritsas was financially supported by Fellowship for Prospective Researchers Grant No. P3SMP3_155290 from the Swiss National Science Foundation. The sponsors had no role in the analysis and interpretation of the data or the manuscript preparation, review, or approval.
MP42-20 PATHOLOGIC OUTCOMES OF CANDIDATES FOR ACTIVE SURVEILLANCE UNDERGOING RADICAL PROSTATECTOMY: RESULTS FROM A CONTEMPORARY TURKISH PATIENT COHORT Ilker Tinay*, Istanbul, Turkey; Guven Aslan, Izmir, Turkey; Ali Riza Kural, Istanbul, Turkey; Haluk Ozen, Turkey; Bulent Akdogan, Ankara, Turkey; Asif Yildirim, Istanbul, Turkey; Ozdal Dillioglugil, Kocaeli, Turkey; Tarik Esen, Istanbul, Turkey; Ferruh Zorlu, Izmir, Turkey; Levent Turkeri, Istanbul, Turkey INTRODUCTION AND OBJECTIVES: To evaluate the pathological outcomes of Turkish men meeting criteria for AS, who elected immediate radical prostatectomy (RP) to assess the risk of undergrading and under-staging in candidates for AS. METHODS: Criteria for potential AS was defined as: clinical stage T2 or lower, PSA 15 ng/mL or lower, Gleason sum 6 or lower(without 4 as primary or secondary), total biopsy cores 8 or more, 33.3% or lower tumor positive cores on biopsy pathology and with at least 2 years follow-up after RP.
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Source of Funding: None