Results The AUA ( American Urological Association ) , ASTRO , and SUO ( Society of Urologic Oncology ) formulated an evidence ‐based guideline based on a risk stratified clinical framework for the management of localized prostate cancer .
Purpose This guideline is structured to provide a clinical framework stratified by cancer severity to facilitate care decisions and guide the specifics of implementing the selected management options .
The summary presented represents Part I of the two‐part series dedicated to Clinical ly Localized Prostate Cancer : AUA/ASTRO/SUO Guideline discussing risk stratification and care options by cancer severity .
Reclassification rates are higher among African American men than Caucasians on active surveillance.
OBJECTIVE To evaluate the risk of reclassification on serial biopsy for Caucasian and African American ( AA ) men with very low-risk ( VLR ) prostate cancer enrolled in a large prospect i ve active surveillance ( AS ) registry . METHODS The Johns Hopkins AS registry is a prospect i ve observational study that has enrolled 982 men since 1994 . Including only men who met all National Comprehensive Cancer Network VLR criteria ( clinical stage ≤T1 , Gleason score ≤6 , prostate-specific antigen [ PSA ] level < 10 ng/mL , PSA density < 0.15 ng/mL/cm(3 ) , positive cores <3 , percent cancer per core ≤50 ) , we analyzed a cohort of 654 men ( 615 Caucasians and 39 AAs ) . The association of race with reclassification on serial biopsy was assessed with competing-risks regressions . RESULTS AA men on AS were more likely than Caucasians to experience upgrading on serial biopsy ( 36 % vs 16 % ; adjusted P < .001 ) . Adjusting for PSA level , prostate size , volume of cancer on biopsy , treatment year , and body mass index , AA race was an independent predictor of biopsy reclassification ( subdistribution hazard ratio , 1.8 ; P = .003 ) . Examining specific modes of reclassification , AA race was independently associated with reclassification by grade ( subdistribution hazard ratio , 3.0 ; P = .002 ) but not by volume . CONCLUSION AA men with VLR prostate cancer followed on AS are at significantly higher risk of grade reclassification compared with Caucasians . Therefore , if the goal of AS is to selectively monitor men with low- grade disease , AA men may require alternate selection criteria
Results The AUA ( American Urological Association ) , ASTRO , and SUO ( Society of Urologic Oncology ) formulated an evidence ‐based guideline based on a risk stratified clinical framework for the management of localized prostate cancer .
Purpose This guideline is structured to provide a clinical framework stratified by cancer severity to facilitate care decisions and guide the specifics of implementing the selected management options .
The summary presented represents Part I of the two‐part series dedicated to Clinical ly Localized Prostate Cancer : AUA/ASTRO/SUO Guideline discussing risk stratification and care options by cancer severity .