Early Experience With Active Surveillance in Low-Risk Prostate Cancer Treated.
10.4111/kju.2014.55.3.167
- Author:
Ji Yong HA
1
;
Byung Hoon KIM
;
Choal Hee PARK
;
Chun Il KIM
Author Information
1. Department of Urology, Keimyung University School of Medicine, Daegu, Korea. cikim@dsmc.or.kr
- Publication Type:Original Article
- Keywords:
Needle biopsy;
Prostate-specific antigen;
Prostatic neoplasms;
Watchful waiting
- MeSH:
Anxiety;
Biopsy;
Biopsy, Needle;
Follow-Up Studies;
Humans;
Kinetics;
Lost to Follow-Up;
Neoplasm Grading;
Patient Selection;
Prostate*;
Prostate-Specific Antigen;
Prostatectomy;
Prostatic Neoplasms*;
Sample Size;
Watchful Waiting
- From:Korean Journal of Urology
2014;55(3):167-171
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: This study was conducted to describe our early experience with active surveillance (AS). MATERIALS AND METHODS: Between January 2008 and December 2012, 35 patients were treated with AS. Selection criteria included the following: Gleason score < or =6 with single positive core, clinical stage < or =T1c, prostate-specific antigen (PSA) < or =10 ng/mL, and unremarkable imaging results. On patient follow-up, we regularly measured PSA (every 3-6 months) and performed prostate biopsies (after 1 and 3 years). RESULTS: In the first year of follow-up, prostate biopsies were performed in 25 patients (13 patients, negative for cancer; 7 patients, Gleason score of 6 without progression; 5 patients, progression, treated with radical prostatectomy [RP]). In the third year of follow-up, prostate biopsies were performed in five patients (two patients, negative for cancer; one patient, Gleason score of 6 without progression; two patients, progression, treated with RP). Seven patients discontinued AS because of increased anxiety, and three patients were lost to follow-up. Overall, seven patients (28%) who experienced progression had a mean PSA doubling time (DT) of 7.54 years. Six patients had a PSA DT of more than 3 years, whereas one had a PSA DT of less than 3 years. This study was limited by its small sample size and short follow-up period. CONCLUSIONS: PSA kinetics did not correlate with progression, which suggests that regular biopsies should still be performed. AS is an available treatment option for patients with a low risk of prostate cancer but should only be used in carefully selected patients.
