PMID- 24904995
OWN - NLM
STAT- MEDLINE
DCOM- 20150325
LR  - 20150121
IS  - 1464-410X (Electronic)
IS  - 1464-4096 (Linking)
VI  - 115
IP  - 2
DP  - 2015 Feb
TI  - Indications for intervention during active surveillance of prostate cancer: a 
      comparison of the Johns Hopkins and Prostate Cancer Research International Active 
      Surveillance (PRIAS) protocols.
PG  - 216-22
LID - 10.1111/bju.12828 [doi]
AB  - OBJECTIVE: To analyse how patients enrolled in our biopsy based surveillance 
      programme would fare under the Prostate Cancer Research International Active 
      Surveillance (PRIAS) protocol, which uses PSA kinetics. PATIENTS AND METHODS: 
      Since 1995, 1125 men with very-low-risk prostate cancer have enrolled in the AS 
      programme at the Johns Hopkins Hospital (JHH), which is based on monitoring with 
      annual biopsy. The PRIAS protocol uses a combination of periodic biopsies (in 
      years 1, 4, and 7) and prostate-specific antigen doubling time (PSADT) to trigger 
      intervention. Patients enrolled in the JHH AS programme were retrospectively 
      reviewed to evaluate how the use of the PRIAS protocol would alter the timing and 
      use of curative intervention. RESULTS: Over a median of 2.1 years of follow up, 
      38% of men in the JHH AS programme had biopsy reclassification. Of those, 62% 
      were detected at biopsy intervals corresponding to the PRIAS criteria, while 16% 
      were detected between scheduled PRIAS biopsies, resulting in a median delay in 
      detection of 1.9 years. Of the 202 men with >5 years of follow-up, 11% in the JHH 
      programme were found to have biopsy reclassification after it would have been 
      identified in the PRIAS protocol, resulting in a median delay of 4.7 years to 
      reclassification. In all, 12% of patients who would have undergone immediate 
      intervention under PRIAS due to abnormal PSA kinetics would never have undergone 
      reclassification on the JHH protocol and thus would not have undergone definitive 
      intervention. CONCLUSIONS: There are clear differences between PSA kinetics-based 
      AS programmes and biopsy based programmes. Further studies should address whether 
      and how the differences in timing of intervention impact subsequent disease 
      progression and prostate cancer mortality.
CI  - (c) 2014 The Authors. BJU International (c) 2014 BJU International.
FAU - Kates, Max
AU  - Kates M
AD  - James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, 
      Baltimore, MD, USA.
FAU - Tosoian, Jeffrey J
AU  - Tosoian JJ
FAU - Trock, Bruce J
AU  - Trock BJ
FAU - Feng, Zhaoyong
AU  - Feng Z
FAU - Carter, H Ballentine
AU  - Carter HB
FAU - Partin, Alan W
AU  - Partin AW
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20140816
PL  - England
TA  - BJU Int
JT  - BJU international
JID - 100886721
RN  - EC 3.4.21.77 (Prostate-Specific Antigen)
SB  - IM
CIN - BJU Int. 2015 Feb;115(2):176-7. PMID: 25604714
MH  - *Biopsy/adverse effects
MH  - *Clinical Protocols
MH  - Disease Progression
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - *Population Surveillance
MH  - Prostate/*pathology
MH  - Prostate-Specific Antigen/*blood
MH  - Prostatic Neoplasms/blood/epidemiology/*pathology/prevention & control
MH  - Reproducibility of Results
MH  - Retrospective Studies
MH  - Sensitivity and Specificity
MH  - United States/epidemiology
MH  - *Watchful Waiting
OTO - NOTNLM
OT  - PSA
OT  - active surveillance
OT  - prostate biopsy
OT  - prostate cancer
EDAT- 2014/06/07 06:00
MHDA- 2015/03/26 06:00
CRDT- 2014/06/07 06:00
PHST- 2014/06/07 06:00 [entrez]
PHST- 2014/06/07 06:00 [pubmed]
PHST- 2015/03/26 06:00 [medline]
AID - 10.1111/bju.12828 [doi]
PST - ppublish
SO  - BJU Int. 2015 Feb;115(2):216-22. doi: 10.1111/bju.12828. Epub 2014 Aug 16.