Premium
Pathological upgrading and upstaging of patients eligible for active surveillance according to currently used protocols
Author(s) -
Kim Tae Heon,
Jeon Hwang Gyun,
Choo Seol Ho,
Jeong Byong Chang,
Seo Seong Il,
Jeon Seong Soo,
Choi Han Yong,
Lee Hyun Moo
Publication year - 2014
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.12326
Subject(s) - medicine , prostatectomy , prostate cancer , watchful waiting , cancer , gynecology , general surgery
Objectives To investigate the ability of six contemporary active surveillance protocols to appropriately select active surveillance candidates among K orean men who underwent radical prostatectomy. Methods Between J anuary 2001 and D ecember 2011, 1968 patients underwent radical prostatectomy for prostate cancer at Samsung Medical Center, Seoul, Korea. Patients met the criteria for active surveillance according to six currently used criteria, including those from the J ohns H opkins H ospital, the U niversity of T oronto, the U niversity of C alifornia at S an F rancisco, the P rospective P rostate C ancer R esearch I nternational A ctive S urveillance, the U niversity of M iami and the M emorial S loan‐ K ettering C ancer C enter. The rates of G leason score upgrading, upstaging and misclassification at final pathology were assessed. Results Among 1006 assessable patients, the percentage of men eligible for active surveillance varied from 13.5% to 38.5%, depending on the criteria used. The rates of upgrading ranged from 41.6% to 50.6%. Extracapsular extension was reported in 4.1% to 8.5% of patients, whereas seminal vesicle invasion was reported in 0.5% to 1.6% of patients. The upstaging rates according to the six active surveillance criteria varied from 4.5% to 9.3%, and the rates of misclassification varied from 44.5% to 54.8%. Conclusions Currently available active surveillance criteria might not be suitable in K orean patients with prostate cancer, as they have a high likelihood of underestimating cancer.