The Association Between Patient and Disease Characteristics, and the Risk of Disease Progression in Patients with Prostate Cancer on Active Surveillance

Overview

Journal World J Urol

Specialty Urology

Date 2024 Feb 19

PMID 38372786

Authors

Matthijs Duijn

Theo M de Reijke

Kurdo Barwari

Marias J Hagens

Sybren P Rynja

Jos Immerzeel

Jelle O Barentsz

Auke Jager

Affiliations

Soon will be listed here.

Abstract

Purpose: The objective of this study was to identify and assess patient and disease characteristics associated with an increased risk of disease progression in men with prostate cancer on active surveillance.

Methods: We studied patients with low-risk (ISUP GG1) or favorable intermediate-risk (ISUP GG2) PCa. All patients had at least one repeat biopsy. Disease progression was the primary outcome of this study, based on pathological upgrading. Univariate and multivariate Cox proportional hazard analyses were used to evaluate the association between covariates and disease progression.

Results: In total, 240 men were included, of whom 198 (82.5%) were diagnosed with low-risk PCa and 42 (17.5%) with favorable intermediate-risk PCa. Disease progression was observed in 42.9% (103/240) of men. Index lesion > 10 mm (HR = 2.85; 95% CI 1.74-4.68; p < 0.001), MRI (m)T-stage 2b/2c (HR = 2.52; 95% CI 1.16-5.50; p = 0.02), highest PI-RADS score of 5 (HR 3.05; 95% CI 1.48-6.28; p = 0.002) and a higher PSA level (HR 1.06; 95% CI 1.01-1.11; p = 0.014) at baseline were associated with disease progression on univariate analysis. Multivariate analysis showed no significant baseline predictors of disease progression.

Conclusion: In AS patients with low-risk or favorable intermediate-risk PCa, diameter of index lesion, MRI (m)T-stage, height of the PI-RADS score and the PSA level at baseline are significant predictors of disease progression to first repeat biopsy.

Citing Articles

Longitudinal evaluation of MRI findings, including quantitative apparent diffusion coefficient values, might be necessary to predict disease progression in patients with prostate cancer on active surveillance.

Mori N World J Urol. 2024; 42(1):191.

PMID: 38530493 DOI: 10.1007/s00345-024-04932-3.

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