MP45-01 PREDICTING PROGRESSION IN PATIENTS FOLLOWED WITH ACTIVE SURVEILLANCE FOR LOW-RISK PROSTATE CANCER (2014)

You have accessJournal of UrologyProstate Cancer: Localized III1 Apr 2014MP45-01 PREDICTING PROGRESSION IN PATIENTS FOLLOWED WITH ACTIVE SURVEILLANCE FOR LOW-RISK PROSTATE CANCER Itay Sternberg, Changhong Yu, Gal Keren Paz, Philip Kim, Melanie Bernstein, Paul Lakin, Michael Kattan, Behfar Ehdaie, Vincent Laudone, Peter Scardino, James Eastham, and Karim Touijer Itay SternbergItay Sternberg More articles by this author , Changhong YuChanghong Yu More articles by this author , Gal Keren PazGal Keren Paz More articles by this author , Philip KimPhilip Kim More articles by this author , Melanie BernsteinMelanie Bernstein More articles by this author , Paul LakinPaul Lakin More articles by this author , Michael KattanMichael Kattan More articles by this author , Behfar EhdaieBehfar Ehdaie More articles by this author , Vincent LaudoneVincent Laudone More articles by this author , Peter ScardinoPeter Scardino More articles by this author , James EasthamJames Eastham More articles by this author , and Karim TouijerKarim Touijer More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1198AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives Due to the inability to predict progression and need for treatment, patients with low-risk prostate cancer (LRPC) managed by active surveillance (AS) are subjected to repeated biopsies and their possible complications. We developed a nomogram predicting the risk of progression in patients on AS for LRPC. Methods A retrospective review of all patients enrolled in an AS program at Memorial Sloan-Kettering Cancer Center (MSKCC) between 1993 and 2012 was conducted. Demographic, clinical, and pathologic data for patients who met the inclusion criteria for AS (cT1 or cT2a, prostate-specific antigen [PSA]<10, Gleason≤6, no more than 3 positive biopsy cores and no >50% involvement of any single core) on the diagnostic and the confirmatory biopsies were collected and used to develop a nomogram for predicting progression-free probability. Multivariable logistic regression analysis was used to model the association between each risk variable (age, PSA levels, clinical stage, biopsy features) and disease progression. Progression was defined as failure to meet the inclusion criteria during follow up. Results A total of 1095 patients were enrolled in an AS program at MSKCC during the study period, of which 680 met the inclusion criteria for AS on both the diagnostic and the confirmatory biopsies and had available follow-up. At a median follow-up of 3 years 101 patients progressed, of which 87 were upgraded to Gleason 7 or higher and 14 progressed based on higher volume of disease. A nomogram predicting the progression-free probability is presented in Figure 1. A concordance index of 0.596 was calculated. Conclusions Conditioned upon external validation, this nomogram can be used to counsel patients on their risk of progression and their surveillance protocol can be adjusted appropriately, possibly avoiding unnecessary biopsies and preventing biopsy-related complications. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e459 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Itay Sternberg More articles by this author Changhong Yu More articles by this author Gal Keren Paz More articles by this author Philip Kim More articles by this author Melanie Bernstein More articles by this author Paul Lakin More articles by this author Michael Kattan More articles by this author Behfar Ehdaie More articles by this author Vincent Laudone More articles by this author Peter Scardino More articles by this author James Eastham More articles by this author Karim Touijer More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...