Pathological upgrading and upstaging of patients eligible for active surveillance according to currently used protocols. (29th October 2013)

• Record Type: Journal Article
• Authors: Kim, Tae Heon; Jeon, Hwang Gyun; Choo, Seol Ho; Jeong, Byong Chang; Seo, Seong Il; Jeon, Seong Soo; Choi, Han Yong; Lee, Hyun Moo
• Is Part Of: International journal of urology. Volume 21:Number 4(2014)
• Page Start: 377
• Page End: 381
• Publication Date: 2013-10-29
• Subjects: Urology -- Periodicals; Genitourinary organs -- Periodicals; Urologic Diseases -- Periodicals; 616.6005
• DOI: 10.1111/iju.12326
• Languages: English
• ISSNs: 0919-8172

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="iju12326-sec-0001" sec-type="section"> <title>Objectives</title> <p>To investigate the ability of six contemporary active surveillance protocols to appropriately select active surveillance candidates among Korean men who underwent radical prostatectomy.</p> </sec> <sec id="iju12326-sec-0002" sec-type="section"> <title>Methods</title> <p>Between January 2001 and December 2011, 1968 patients underwent radical prostatectomy for prostate cancer at Samsung Medical Center, Seoul, Korea. Patients met the criteria for active surveillance according to six currently used criteria, including those from the Johns Hopkins Hospital, the University of Toronto, the University of California at San Francisco, the Prospective Prostate Cancer Research International Active Surveillance, the University of Miami and the Memorial Sloan‐Kettering Cancer Center. The rates of Gleason score upgrading, upstaging and misclassification at final pathology were assessed.</p> </sec> <sec id="iju12326-sec-0003" sec-type="section"> <title>Results</title> <p>Among 1006 assessable patients, the percentage of men eligible for active surveillance varied from 13.5% to 38.5%, depending on the criteria used. The rates of upgrading ranged from 41.6% to 50.6%. Extracapsular extension was reported in 4.1% to 8.5% of patients, whereas seminal vesicle invasion was reported in 0.5% to 1.6% of patients. The upstaging rates according to the six active surveillance criteria varied from 4.5% to 9.3%, and the rates of misclassification varied from 44.5% to 54.8%.</p> </sec> <sec id="iju12326-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Currently available active surveillance criteria might not be suitable in Korean patients with prostate cancer, as they have a high likelihood of underestimating cancer.</p> </sec> </abstract>