Changes in Gleason score grading on serial follow-up biopsies in prostate cancer patients undergoing active surveillance.
Actas Urol Esp
; 39(3): 139-43, 2015 Apr.
Article
in En, Es
| MEDLINE
| ID: mdl-25305107
ABSTRACT
INTRODUCTION:
Active surveillance for prostate cancer has grown systematically in the recent years with more robust mid-term outcomes. However, changes in Gleason score during serial biopsies are not detailed in many of these reports.OBJECTIVES:
To evaluate changes in Gleason score on follow-up biopsies in low-risk prostate cancer in patients undergoing AS program in our center. MATERIAL ANDMETHODS:
Series of patients diagnosed of prostate cancer between 2004 and 2013 have been analyzed. The inclusion criteria were PSA ≤ 10 ng/ml + Gleason ≤ 6 + T1c/T2a + ≤ 2 positive cores, and no more than 50% of affected core. The pathology of each of the biopsies was analyzed.RESULTS:
We studied a series of 175 patients undergoing AS. Mean follow-up was 3.96 years (SD 2.4). Follow-up biopsies with Gleason scores ≥ 7 were 5.72% in the first biopsy, 7.39% and 7.41% in subsequent biopsies. By contrast, in 42.03% of cases did not show evident tumor involvement in the first biopsy, 40.74% and 51.85% in the second and third biopsies respectively. Median stay in the AS program was 90.99 months (95% CI 53.53-128.46) in patients with first positive biopsy vs. 96.66 months (95% CI 63.19-130.13) in those without evidence of tumor.CONCLUSIONS:
In our series the pathological data of the first 3 biopsies remain stable in terms of the positive biopsy rate, Gleason score, or indication of active treatment proportions. Those patients who do not show evidence of malignancy in the first follow-up biopsy are less likely to need active treatment than the other patients in the series.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Prostatic Neoplasms
/
Adenocarcinoma
/
Watchful Waiting
/
Neoplasm Grading
Type of study:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Limits:
Aged
/
Humans
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Male
/
Middle aged
Language:
En
/
Es
Year:
2015
Type:
Article