https://doi.org/10.4081/aiua.2021.4.385
Outcomes of active surveillance for clinically localized prostate cancer in a middle eastern tertiary care center
Submitted: May 14, 2021
Accepted: July 19, 2021
Published: December 20, 2021
Accepted: July 19, 2021
Abstract Views: 1144
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Background: The aim of our study was to evaluate the outcome of active surveillance (AS) for prostate cancer for a cohort of patients at our institution.
Methods: A total of 43 patients with low risk prostate cancer were enrolled in an active surveillance pilot program at our institution between 2008 and 2018. Follow up protocols included: periodic prostate specific antigen (PSA), digital rectal examination (DRE), multiparametric MRI, and prostate biopsy at one year. Pertinent parameters were collected, and descriptive statistics were reported along with a subset analysis of patients that dropped out of the protocol to receive active treatment for disease progression.
Results: Out of 43 eligible patients, 46.5% had a significant rise in follow up PSA. DRE was initially suspicious in 27.9% of patients, and none had any change in DRE on follow up. Initially, prostate MRIs showed PIRADS 3, 4, and 5 in 14%, 37.2%, and 11.6% respectively, while 23.2% had a negative initial MRI. 14% did not have an MRI. Upon follow up, 18.6% of patients had progression on MRI. Initial biopsies revealed that 86% were classified as WHO group 1, while 14% as WHO group 2. With regards to the follow up biopsies, 11.6% were upgraded. 20.9% of our patients had active treatment; 44.4% due to upgraded biopsy results, 22.2% due to PSA progression, 22.2% due to strong patient preference, and 11.1% due to radiologic progression.
Conclusions: For selected men with low risk prostate cancer, AS is a reasonable alternative. The decision for active treatment should be tailored upon changes in PSA, DRE, MRI, and biopsy results.
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How to Cite
Hout, M., Merhe, A., Heidar, N. A., El-Asmar, J. M., Wazzan, W., Bachir, B., Jaafar, R., El-Hajj, A., & Bulbul, M. (2021). Outcomes of active surveillance for clinically localized prostate cancer in a middle eastern tertiary care center. Archivio Italiano Di Urologia E Andrologia, 93(4), 385–388. https://doi.org/10.4081/aiua.2021.4.385
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