Q Bandelier, C Bastide, A-L Charvet, L Leclercq, B Gondran-Tellier, J Campagna, T Long-Depaquit, L Daniel, D Rossi, E Lechevallier, M Baboudjian
{"title":"积极监测有利的中盘前列腺癌症：单中心经验。","authors":"Q Bandelier, C Bastide, A-L Charvet, L Leclercq, B Gondran-Tellier, J Campagna, T Long-Depaquit, L Daniel, D Rossi, E Lechevallier, M Baboudjian","doi":"10.1016/j.purol.2023.09.024","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To report the long-term oncological outcomes of active surveillance (AS) in selected patients with favorable intermediate-risk (IR) prostate cancer (PCa).</p><p><strong>Methods: </strong>A retrospective database review of two academic centers was conducted to identify favorable IR PCa patients initially managed by AS between 2014 and 2022. Favorable IR PCa was defined by the presence of one single element of IR disease (i.e., PSA 10-20ng/mL, Gleason Grade Group [GG] 2, or cT2b). All patients were diagnosed and followed up according to a contemporary scheme, including MRI and image-guided biopsies. The primary endpoint was metastasis-free survival.</p><p><strong>Results: </strong>A total of 57 patients met our inclusion criteria and the median follow-up was 56months. During follow-up, there were no cases of metastasis or death due to PCa, but 6 deaths due to competing causes. A total of 25 (44%) and 6 patients (11%) had definitive treatment and GG 3 reclassification during follow-up, respectively. In multivariable Cox hazard regression analysis, the risk of undergoing definitive treatment was significantly associated with PSA density>0.15 (HR: 4.82, 95% CI: 1.47 to 15; P=0.01) and PI-RADS 4-5 lesions on mpMRI (HR: 2.48, 95% CI: 1.06 to 5.19; P=0.006). Interestingly, tumor burden (P=0.3) and GG (P=0.7) on biopsy were not associated with definitive treatment.</p><p><strong>Conclusions: </strong>AS is a safe and valuable strategy for well-selected patients with favorable IR prostate cancer, with excellent oncological outcomes after five years' follow-up.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":20635,"journal":{"name":"Progres En Urologie","volume":" ","pages":"102537"},"PeriodicalIF":0.8000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Active surveillance in favorable intermediate-risk prostate cancer: A single-center experience.\",\"authors\":\"Q Bandelier, C Bastide, A-L Charvet, L Leclercq, B Gondran-Tellier, J Campagna, T Long-Depaquit, L Daniel, D Rossi, E Lechevallier, M Baboudjian\",\"doi\":\"10.1016/j.purol.2023.09.024\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To report the long-term oncological outcomes of active surveillance (AS) in selected patients with favorable intermediate-risk (IR) prostate cancer (PCa).</p><p><strong>Methods: </strong>A retrospective database review of two academic centers was conducted to identify favorable IR PCa patients initially managed by AS between 2014 and 2022. Favorable IR PCa was defined by the presence of one single element of IR disease (i.e., PSA 10-20ng/mL, Gleason Grade Group [GG] 2, or cT2b). All patients were diagnosed and followed up according to a contemporary scheme, including MRI and image-guided biopsies. The primary endpoint was metastasis-free survival.</p><p><strong>Results: </strong>A total of 57 patients met our inclusion criteria and the median follow-up was 56months. During follow-up, there were no cases of metastasis or death due to PCa, but 6 deaths due to competing causes. A total of 25 (44%) and 6 patients (11%) had definitive treatment and GG 3 reclassification during follow-up, respectively. In multivariable Cox hazard regression analysis, the risk of undergoing definitive treatment was significantly associated with PSA density>0.15 (HR: 4.82, 95% CI: 1.47 to 15; P=0.01) and PI-RADS 4-5 lesions on mpMRI (HR: 2.48, 95% CI: 1.06 to 5.19; P=0.006). 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Active surveillance in favorable intermediate-risk prostate cancer: A single-center experience.
Purpose: To report the long-term oncological outcomes of active surveillance (AS) in selected patients with favorable intermediate-risk (IR) prostate cancer (PCa).
Methods: A retrospective database review of two academic centers was conducted to identify favorable IR PCa patients initially managed by AS between 2014 and 2022. Favorable IR PCa was defined by the presence of one single element of IR disease (i.e., PSA 10-20ng/mL, Gleason Grade Group [GG] 2, or cT2b). All patients were diagnosed and followed up according to a contemporary scheme, including MRI and image-guided biopsies. The primary endpoint was metastasis-free survival.
Results: A total of 57 patients met our inclusion criteria and the median follow-up was 56months. During follow-up, there were no cases of metastasis or death due to PCa, but 6 deaths due to competing causes. A total of 25 (44%) and 6 patients (11%) had definitive treatment and GG 3 reclassification during follow-up, respectively. In multivariable Cox hazard regression analysis, the risk of undergoing definitive treatment was significantly associated with PSA density>0.15 (HR: 4.82, 95% CI: 1.47 to 15; P=0.01) and PI-RADS 4-5 lesions on mpMRI (HR: 2.48, 95% CI: 1.06 to 5.19; P=0.006). Interestingly, tumor burden (P=0.3) and GG (P=0.7) on biopsy were not associated with definitive treatment.
Conclusions: AS is a safe and valuable strategy for well-selected patients with favorable IR prostate cancer, with excellent oncological outcomes after five years' follow-up.
期刊介绍：
Une publication rapide des travaux en urologie: retrouvez les derniers travaux de recherche, études et enquêtes, en Urologie, publiés sous la forme de revues, mises au point, articles originaux, notes techniques, cas cliniques pertinents et originaux, lettres à la rédaction, revues de la littérature, textes de recommandation,... La revue publie également des articles pour les infirmières en Urologie. Une approche pluridisciplinaire : Progrès en Urologie aborde toutes les pathologies urologiques. Aux 13 numéros de Progrès viennent s''ajouter 4 numéros de Progrès en Urologie Pelvi-Périnéologie
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