To report oncological outcomes of patients with prostate cancer undergoing active surveillance according to SURACAP criteria.
This multicentric study included patients who were initially treated with active surveillance for localized prostate cancer according to the SURACAP criteria. The duration of active surveillance as well as the causes of discontinuing the protocol and the definitive pathological results of patients who further underwent radical prostatectomy were retrospectively evaluated. The predictors of discontinuing active surveillance were assessed using a univariable Cox Model. In addition, the predictive value of initial MRI was assessed for patients who performed such imagery.
Between 2007 and 2013, 80 patients were included, with a median age of 64 years [47-74]. Median follow-up was 52.9 months [24-108]. At 5 years follow-up, 43.4% patients were still under surveillance. Among patients that underwent surgery, 17.8% had an extra-capsular extension. The risk of discontinuing was not significantly greater for patients with tumor size of 2 or 3mm versus 1mm (HR=0.9 [0.46-1.75], P=0.763), 2 positives cores versus 1 (HR=0.98 [0.48-2.02], P=0.967), T2a vs. T1c stage (HR=2.18 [0.77-6.18], P=0.133), increased PSA level (HR=1 [0.96-1.15], P=0.975) or the patient's age (HR=1 [0.93-1.16], P=0.966). Among the 50 patients who performed initial MRI, the results of such imagery was not significantly associated to the risk of discontinuing active surveillance MRI (HR=1.49 [0.63-3.52], P=0.36).
Although this study reveals a high rate of release from active surveillance at 5 years, the rate of extra-capsular tumors reported in the group of patients that underwent surgery is among the lowest in literature.
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Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie. 2016 Dec 13 [Epub ahead of print]
P Mortier, C Bastide, E Lechevallier, J Walz, R Fournier, P-H Savoie, K Ben Othman, R Giorgi, M André, S Giusiano, D Rossi
Service d'urologie, hôpital nord, chemin des Bourrely, 13015 Marseille, France. Electronic address: ., Service d'urologie, hôpital nord, chemin des Bourrely, 13015 Marseille, France. Electronic address: ., Service d'urologie et de transplantation rénale, hôpital de La Conception, 147, boulevard Baille, 13005 Marseille, France. Electronic address: ., Service de chirurgie oncologique urologique, institut Paoli-Calmettes, 232, boulevard de Sainte-Marguerite, 13009 Marseille, France. Electronic address: ., Service d'urologie, hôpital d'instruction des armées Sainte-Anne, 2, boulevard Sainte-Anne, 83800 Toulon, France., Service d'urologie et de transplantation rénale, hôpital de La Conception, 147, boulevard Baille, 13005 Marseille, France. Electronic address: ., Sciences économiques et sociales de la santé et traitement de l'information médicale (SESSTIM), UMR 912, Inserm, IRD, faculté de médecine, Aix-Marseille université, 27, boulevard Jean-Moulin, 13385 Marseille cedex 05, France. Electronic address: ., Service de radiologie et imagerie médicale, hôpital de La Conception, 147, boulevard Baille, 13005 Marseille, France. Electronic address: ., Service d'anatomie pathologique, hôpital nord, chemin des Bourrely, 13015 Marseille, France. Electronic address: ., Service d'urologie, hôpital nord, chemin des Bourrely, 13015 Marseille, France. Electronic address: .