Abstract | PURPOSE: Active surveillance for early prostate cancer is a policy of close monitoring with radical treatment targeted at cases with evidence of disease progression. There is no consensus on the need for or optimum timing of repeat biopsies as part of active surveillance. MATERIALS AND METHODS: In a prospective cohort study of active surveillance 119 patients with untreated localized prostate cancer (T1/2a), prostate specific antigen less than 15 ng/ml, Gleason score 3 + 4 or less and 50% or less positive cores underwent repeat biopsy after 18 to 24 months. Histological disease progression was defined as primary Gleason grade 4 or greater, greater than 50% positive cores or a Gleason score increase from 6 or less to 7 or greater. The risk of histological disease progression was analyzed with respect to baseline clinical factors. RESULTS: CONCLUSIONS: Repeat biopsy should be an integral part of active surveillance for untreated localized prostate cancer. Immediate repeat biopsy should be considered in patients who elect active surveillance but who have prostate specific antigen density greater than 0.2 ng/ml/ml. These findings must be validated in a cohort of patients with extended biopsies at diagnosis and followup.
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Authors | Ramachandran Venkitaraman, Andrew Norman, Ruth Woode-Amissah, Cyril Fisher, David Dearnaley, Alan Horwich, Robert Huddart, Vincent Khoo, Alan Thompson, Chris Parker |
Journal | The Journal of urology
(J Urol)
Vol. 178
Issue 3 Pt 1
Pg. 833-7
(Sep 2007)
ISSN: 0022-5347 [Print] United States |
PMID | 17631355
(Publication Type: Journal Article)
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Chemical References |
- Prostate-Specific Antigen
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Topics |
- Aged
- Biopsy, Needle
- Disease Progression
- Humans
- Male
- Middle Aged
- Prostate
(pathology)
- Prostate-Specific Antigen
(blood)
- Prostatic Neoplasms
(diagnosis, pathology, therapy)
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