Korean J Urol.  2014 Mar;55(3):167-171. 10.4111/kju.2014.55.3.167.

Early Experience With Active Surveillance in Low-Risk Prostate Cancer Treated

• Ha JY
• Kim BH
• Park CH
• Kim CI

• KMID: 1988419
• DOI: http://doi.org/10.4111/kju.2014.55.3.167

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 < or =6 with single positive core, clinical stage < or =T1c, prostate-specific antigen (PSA) < or =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.

Keyword

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

MeSH Terms

Anxiety
Biopsy
Biopsy, Needle
Follow-Up Studies
Humans
Kinetics
Lost to Follow-Up
Neoplasm Grading
Patient Selection
Prostate*
Prostate-Specific Antigen
Prostatectomy
Prostatic Neoplasms*
Sample Size
Watchful Waiting
Prostate-Specific Antigen

Figure

• 

  FIG. 1 Flow chart of AS in 35 patients. AS, active surveillance; RP, radical prostatectomy; HT, hormone therapy; T/F, transfer.

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