Association between previous negative biopsies and lower rates of progression during active surveillance for prostate cancer.
World J Urol
; 40(6): 1447-1454, 2022 Jun.
Article
en En
| MEDLINE
| ID: mdl-35347414
ABSTRACT
PURPOSE:
To test any-cause discontinuation and ISUP GG upgrading rates during Active Surveillance (AS) in patients that underwent previous negative biopsies (PNBs) before prostate cancer (PCa) diagnosis vs. biopsy naive patients.METHODS:
Retrospective analysis of 961 AS patients (2008-2020). Three definitions of PNBs were used (1) PNBs status (biopsy naïve vs. PNBs); (2) number of PNBs (0 vs. 1 vs. ≥ 2); (3) histology at last PNB (no vs. negative vs. HGPIN/ASAP). Kaplan-Meier plots and multivariable Cox models tested any-cause and ISUP GG upgrading discontinuation rates.RESULTS:
Overall, 760 (79.1%) vs. 201 (20.9%) patients were biopsy naïve vs. PNBs. Specifically, 760 (79.1%) vs. 138 (14.4%) vs. 63 (6.5%) patients had 0 vs. 1 vs. ≥ 2 PNBs. Last, 760 (79.1%) vs. 134 (13.9%) vs. 67 (7%) patients had no vs. negative PNB vs. HGPIN/ASAP. PNBs were not associated with any-cause discontinuation rates. Conversely, PNBs were associated with lower rates of ISUP GG upgrading (1) PNBs vs. biopsy naïve (HR0.6, p = 0.04); (2) 1 vs. 0 PNBs (HR0.6, p = 0.1) and 2 vs. 0 PNBs, (HR0.5, p = 0.1); (3) negative PNB vs. biopsy naïve (HR0.7, p = 0.3) and HGPIN/ASAP vs. biopsy naïve (HR0.4, p = 0.04). However, last PNB ≤ 18 months (HR0.4, p = 0.02), but not last PNB > 18 months (HR0.8, p = 0.5) were associated with lower rates of ISUP GG upgrading.CONCLUSION:
PNBs status is associated with lower rates of ISUP GG upgrading during AS for PCa. The number of PNBs and time from last PNB to PCa diagnosis (≤ 18 months) appear also to be critical for patient selection.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Neoplasias de la Próstata
/
Neoplasia Intraepitelial Prostática
Tipo de estudio:
Diagnostic_studies
/
Observational_studies
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Prognostic_studies
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Risk_factors_studies
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Screening_studies
Límite:
Humans
/
Male
Idioma:
En
Revista:
World J Urol
Año:
2022
Tipo del documento:
Article
País de afiliación:
Italia