prostate-report.org

Pathological outcomes and criteria for active surveillance protocols

A recent study has used the University of California San Francisco database to evaluate the pathological outcomes of men meeting published criteria for active surveillance who elected immediate radical prostatectomy to assess the risk of under-grading and under-staging in candidates for active surveillance.

Researchers identified 1,097 men who underwent radical prostatectomy with a mean age of 59 years. Overall, 28 percent of the men experienced a Gleason upgrade, 21 percent had extracapsular extension, and 11 percent had seminal vesicle involvement. In men qualifying based on published active surveillance inclusion criteria, rates of upgrading varied between 23 and 35 percent, the incidence of extracapsular extension ranged from 7 to 19 percent, and seminal vesicle involvement ranged from 2 to 9 percent.

The authors conclude that varying study entry criteria for active surveillance studies show different rates of adverse pathological features at radical prostatectomy. Apparently, predictably fewer men met the more stringent criteria but these men had a lower incidence of seminal vesicle involvement and extracapsular extension.