PMID- 38093673
OWN - NLM
STAT- MEDLINE
DCOM- 20240423
LR  - 20240424
IS  - 1464-410X (Electronic)
IS  - 1464-4096 (Linking)
VI  - 133
IP  - 5
DP  - 2024 May
TI  - Medium-term follow up of active surveillance for early prostate cancer at a 
      non-academic institution.
PG  - 614-621
LID - 10.1111/bju.16259 [doi]
AB  - OBJECTIVES: To report oncological outcomes of active surveillance (AS) at a 
      single non-academic institution adopting the standardised Prostate Cancer 
      Research International Active Surveillance (PRIAS) protocol. PATIENTS AND 
      METHODS: Competing risk analyses estimated the incidence of overall mortality, 
      metastases, conversion to treatment, and grade reclassification. The incidence of 
      reclassification and adverse pathological findings at radical prostatectomy were 
      compared between patients fulfilling all PRIAS inclusion criteria vs those not 
      fulfilling at least one. RESULTS: We analysed 341 men with Grade Group 1 prostate 
      cancer (PCa) followed on AS between 2010 and 2022. There were no PCa deaths, two 
      patients developed distant metastases and were alive at the end of the study 
      period. The 10-year cumulative incidence of metastases was 1.9% (95% confidence 
      interval [CI] 0.33-6.4%). A total of 111 men were reclassified, and 127 underwent 
      definitive treatment. Men not fulfilling at least one PRIAS inclusion criteria 
      (n = 43) had a higher incidence of reclassification (subdistribution hazards 
      ratio 1.73, 95% CI 1.07-2.81; P = 0.03), but similar rates of adverse 
      pathological findings at radical prostatectomy. CONCLUSION: Metastases in men on 
      AS at a non-academic institution are as rare as those reported in established 
      international cohorts. Men followed without stringent inclusion criteria should 
      be counselled about the higher incidence of reclassification and reassured they 
      can expect rates of adverse pathological findings comparable to those fulfilling 
      all criteria. Therefore, AS should be proposed to all men with low-grade PCa 
      regardless of whether they are followed at academic institutions or smaller 
      community hospitals.
CI  - (c) 2023 BJU International.
FAU - Leni, Riccardo
AU  - Leni R
AD  - Division of Experimental Oncology, Department of Urology, IRCCS San Raffaele 
      Scientific Institute, Milan, Italy.
AD  - Vita-Salute San Raffaele University, Milan, Italy.
FAU - Roscigno, Marco
AU  - Roscigno M
AUID- ORCID: 0000-0002-5241-6767
AD  - University of Milano-Bicocca, Milan, Italy.
AD  - Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy.
FAU - Barzaghi, Paolo
AU  - Barzaghi P
AD  - Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy.
FAU - La Croce, Giovanni
AU  - La Croce G
AD  - Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy.
FAU - Catellani, Michele
AU  - Catellani M
AD  - Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy.
FAU - Sacca, Antonino
AU  - Sacca A
AD  - Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy.
FAU - de Angelis, Mario
AU  - de Angelis M
AD  - Division of Experimental Oncology, Department of Urology, IRCCS San Raffaele 
      Scientific Institute, Milan, Italy.
AD  - Vita-Salute San Raffaele University, Milan, Italy.
FAU - Montorsi, Francesco
AU  - Montorsi F
AUID- ORCID: 0000-0002-7267-4181
AD  - Division of Experimental Oncology, Department of Urology, IRCCS San Raffaele 
      Scientific Institute, Milan, Italy.
AD  - Vita-Salute San Raffaele University, Milan, Italy.
FAU - Briganti, Alberto
AU  - Briganti A
AD  - Division of Experimental Oncology, Department of Urology, IRCCS San Raffaele 
      Scientific Institute, Milan, Italy.
AD  - Vita-Salute San Raffaele University, Milan, Italy.
FAU - Da Pozzo, Luigi Filippo
AU  - Da Pozzo LF
AD  - University of Milano-Bicocca, Milan, Italy.
AD  - Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy.
LA  - eng
PT  - Journal Article
DEP - 20240122
PL  - England
TA  - BJU Int
JT  - BJU international
JID - 100886721
SB  - IM
MH  - Humans
MH  - Male
MH  - *Prostatic Neoplasms/pathology/surgery/therapy/mortality
MH  - *Watchful Waiting
MH  - Middle Aged
MH  - Aged
MH  - Follow-Up Studies
MH  - Prostatectomy
MH  - Neoplasm Grading
MH  - Neoplasm Metastasis
OTO - NOTNLM
OT  - active surveillance
OT  - follow-up
OT  - metastases
OT  - prostate cancer
OT  - reclassification
EDAT- 2023/12/14 06:42
MHDA- 2024/04/23 15:49
CRDT- 2023/12/14 03:34
PHST- 2024/04/23 15:49 [medline]
PHST- 2023/12/14 06:42 [pubmed]
PHST- 2023/12/14 03:34 [entrez]
AID - 10.1111/bju.16259 [doi]
PST - ppublish
SO  - BJU Int. 2024 May;133(5):614-621. doi: 10.1111/bju.16259. Epub 2024 Jan 22.