Factores clínicos e histológicos predictores de reclasificación en pacientes incluidos en programa de vigilancia activa de cáncer de próstata |
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| Institution: | 1. Servicio de Urología, Hospital General Universitario de Castellón, Castellón, España;2. Servicio de Urología, Hospital La Plana (Vila-Real), Castellón, España;1. Department of Urology, Policlinico San Martino Hospital, University of Genova, Genova, Italy;2. European Society of Residents in Urology (ESRU), Arnhem, The Netherlands;3. Department of Urology, La Paz University Hospital, Madrid, Autonomous University of Madrid, Madrid, Spain;4. Department of Urology, Cruces University Hospital, Barakaldo, Vizcaya, Spain;5. Department of Oncology and Metabolism, Academic Urology Unit, University of Sheffield, Sheffield, United Kingdom;6. Department of Urology, Campus Biomedico, University of Rome, Rome, Italy;7. Department of Urology, Sestre Milosrdnice University Hospital Centre, Zagreb, Croatia;8. Department of Urology, Hospital Clínico San Carlos, Madrid, Spain;1. Servicio de Urología, Hospital Clínic, Barcelona, España;2. Pharmacoeconomics & Outcomes Research Iberia (PORIB), Madrid, España;3. Unidad de Urología Reconstructiva y Andrología, Servicio de Urología, Hospital Universitario de Navarra, Pamplona, España;4. Health Economics & Market Access, Boston Scientific Iberia, Madrid, España;5. Sección de Urología Funcional, Reconstructiva y Andrología, Servicio de Urología, Hospital General Universitario Gregorio Marañón, Madrid, España;1. Department of Urology, Lenox Hill Hospital, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, New York, EE. UU.;2. Advanced Urological Care, PC, New York, EE. UU.;1. Department of Surgery, Division of Urology, McGill University, Montréal, Canadá;2. Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italia;1. Amasya University, Faculty of Medicine, Urology Department, Amasya, Turquía;2. UHC Istanbul Bakırkoy Sadi Konuk Training and Research Hospital, Urology Department, Estambul, Turquía;3. UHC İzmir Bozyaka Training and Research Hospital, Urology Department, Bozyaka, Turquía;4. Istanbul Medipol University, Urology Department, Estambul, Turquía;5. UHC Istanbul Umraniye Training and Research Hospital, Urology Department, Estambul, Turquía;6. Kocaeli University, Faculty of Medicine, Urology Department, Kocaeli, Turquía |
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| Abstract: | Introduction and ObjectiveActive surveillance (AS) has been established as a therapeutic strategy in patients with low-risk prostate cancer. Demographic and anatomopathological factors that increase the probability of reclassifying patients have been identified.Materials and MethodsLaboratory and histopathological data were collected from 116 patients included on AS since 2014. Univariate analysis was performed with Chi-square, t-student and Kendall's Tau, multivariate analysis according to logistic regression and Kaplan-Meier curves were calculated.ResultsOf the 116 patients in AS, the median age at diagnosis was 66 years and the median follow-up was 13 months (2-72). Of these, 61 (52.6%) are still on surveillance, while 55 (47.4%) have left the program, mostly due to histological progression (52 patients (45.2%)); radical prostatectomy was performed in 27 (49.1%). Prostate volume (PV) ≤ 60cc and the number of positive cylinders > 1 in diagnostic biopsy (p = 0.05) were associated with higher reclassification rate in univariate analysis (p < 0.05). Multivariate analysis showed that these two variables significantly correlated with higher reclassification rate (PV 60 cc: OR 4.39, p = 0.04; > 1 positive cylinder at diagnostic biopsy: OR 2.48, p = 0.03).ConclusionsIt has been shown that initial ultrasound volume and the number of positive cylinders in the diagnostic biopsy are independent risk factors for reclassification. Initial PSA, laterality of the affected cylinders and PSA density were not predictive factors of progression in our series. |
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| Keywords: | Active surveillance Prostate cancer Progression |
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