Clinical and histological predictive factors of reclassification of prostate cancer patients on active surveillance.
Actas Urol Esp (Engl Ed)
; 47(5): 303-308, 2023 06.
Article
em En, Es
| MEDLINE
| ID: mdl-37272322
ABSTRACT
INTRODUCTION AND OBJECTIVE:
Active surveillance (AS) has been established as a therapeutic strategy in patients with low-risk prostate cancer. Demographic and anatomopathological factors that increase the probability of reclassifying patients have been identified. MATERIALS ANDMETHODS:
Laboratory and histopathological data were collected from 116 patients included on AS since 2014. Univariate analysis was performed with Chi-square, t-student and Kendall's Tau, multivariate analysis according to logistic regression and Kaplan-Meier curves were calculated.RESULTS:
Of the 116 patients in AS, the median age at diagnosis was 66 years and the median follow-up was 13 months (2-72). Of these, 61 (52.6%) are still on surveillance, while 55 (47.4%) have left the program, mostly due to histological progression (52 patients (45.2%)); radical prostatectomy was performed in 27 (49.1%). Prostate volume (PV)≤60cc and the number of positive cylinders >1 in diagnostic biopsy (P=.05) were associated with higher reclassification rate in univariate analysis (P<.05). Multivariate analysis showed that these two variables significantly correlated with higher reclassification rate (PV 60 cc OR 4.39, P=.04; >1 positive cylinder at diagnostic biopsy OR 2.48, P=.03).CONCLUSIONS:
It has been shown that initial ultrasound volume and the number of positive cylinders in the diagnostic biopsy are independent risk factors for reclassification. Initial PSA, laterality of the affected cylinders and PSA density were not predictive factors of progression in our series.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
/
Tipos_de_cancer
/
Prostata
Base de dados:
MEDLINE
Assunto principal:
Neoplasias da Próstata
/
Antígeno Prostático Específico
Tipo de estudo:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Limite:
Humans
/
Male
Idioma:
En
/
Es
Revista:
Actas Urol Esp (Engl Ed)
Ano de publicação:
2023
Tipo de documento:
Article