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Korean J Urol. 2014 Mar;55(3):167-71. doi: 10.4111/kju.2014.55.3.167. Epub 2014 Mar 13.

Early experience with active surveillance in low-risk prostate cancer treated.

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1
Department of Urology, Keimyung University School of Medicine, Daegu, Korea.

Abstract

PURPOSE:

This study was conducted to describe our early experience with active surveillance (AS).

MATERIALS AND METHODS:

Between January 2008 and December 2012, 35 patients were treated with AS. Selection criteria included the following: Gleason score ≤6 with single positive core, clinical stage ≤T1c, prostate-specific antigen (PSA) ≤10 ng/mL, and unremarkable imaging results. On patient follow-up, we regularly measured PSA (every 3-6 months) and performed prostate biopsies (after 1 and 3 years).

RESULTS:

In the first year of follow-up, prostate biopsies were performed in 25 patients (13 patients, negative for cancer; 7 patients, Gleason score of 6 without progression; 5 patients, progression, treated with radical prostatectomy [RP]). In the third year of follow-up, prostate biopsies were performed in five patients (two patients, negative for cancer; one patient, Gleason score of 6 without progression; two patients, progression, treated with RP). Seven patients discontinued AS because of increased anxiety, and three patients were lost to follow-up. Overall, seven patients (28%) who experienced progression had a mean PSA doubling time (DT) of 7.54 years. Six patients had a PSA DT of more than 3 years, whereas one had a PSA DT of less than 3 years. This study was limited by its small sample size and short follow-up period.

CONCLUSIONS:

PSA kinetics did not correlate with progression, which suggests that regular biopsies should still be performed. AS is an available treatment option for patients with a low risk of prostate cancer but should only be used in carefully selected patients.

KEYWORDS:

Needle biopsy; Prostate-specific antigen; Prostatic neoplasms; Watchful waiting

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