| ORIGINAL ARTICLE |
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| Year : 2015 | Volume
: 17
| Issue : 2 | Page : 248-252 |
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Analysis of expanded criteria to select candidates for active surveillance of low-risk prostate cancer
Jung Ki Jo, Han Sol Lee, Young Ik Lee, Sang Eun Lee, Sung Kyu Hong
Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea
Correspondence Address:
Sung Kyu Hong
Department of Urology, Seoul National University Bundang Hospital, Seongnam
Korea
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/1008-682X.142136
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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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