OBJECTIVE: To determine whether there are differences in the oncological outcomes after radical prostatectomy (adverse patology and biochemical recurrence) based on clinical selection criteria used in two active surveillance (AS) protocols.
MATERIAL AND METHODS: 442 patients diagnosed with localized prostate cancer (CP) underwent radical prostatectomy at our institution between August 2003 and December 2009. We selected patients with low-risk CP, which could have been included in an AS program. Patients were divided into two groups: group i, those who met the most strict surveillance criteria described by Epstein (PSAD< .15; T1/T2a;< 2 positive core, Gleason≤ 6,< 50% involvement of the core) and group ii, those meeting the more open criteria described by Klotz (PSA≤ 10 or< 15 at age 70, Gleason≤ 6 or< 7 [3+4] in over 70 years). We compared both groups to determine differences in pathological stage, positive surgical margins and biochemical recurrence after radical prostatectomy.
RESULTS: Of the 442 patients 48% (213 patients) had low-risk PC, and become potential candidates for an AS program. Of the patients operated on 17% (76 patients) met the criteria for AS as of Epstein's and 48% (213 patients) according to Klotz. Comparing patients in both groups there were no statistically significant differences in the presence of pT3 (7.9% vs 10.8%) P=.55, positive margins (22.4% vs. 28.3%) P=.41, nor in biochemical recurrence at 3 years (5.3% vs 5.6%) P=.86.
CONCLUSIONS: In our series of patients theoretically candidates for inclusion in a program of active surveillance, we found no differences in the percentage of patients with pathological stage pT3, positive margins and biochemical recurrence according to clinical inclusion criteria currently used.
Written by:
Blázquez C, Hernández V, de la Peña E, Díaz FJ, Martin MD, de la Morena JM, Llorente C. Are you the author?
Servicio de Urología, Hospital Universitario Fundación Alcorcón, Madrid, España.
Reference: Actas Urol Esp. 2013 Jul 10. pii: S0210-4806(13)00163-0.
doi: 10.1016/j.acuro.2013.02.015
PubMed Abstract
PMID: 23850164
Article in English, Spanish.
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