PD34-03 TIMING OF THE CONFIRMATORY BIOPSY IN PROSTATE CANCER ACTIVE SURVEILLANCE: ANALYSIS OF THE CANARY PROSTATE CANCER ACTIVE SURVEILLANCE STUDY (PASS) (2015)

You have accessJournal of UrologyProstate Cancer: Localized IV1 Apr 2015PD34-03 TIMING OF THE CONFIRMATORY BIOPSY IN PROSTATE CANCER ACTIVE SURVEILLANCE: ANALYSIS OF THE CANARY PROSTATE CANCER ACTIVE SURVEILLANCE STUDY (PASS) Liam C. Macleod, William J. Ellis, Lisa F. Newcomb, Yingye Zheng, James D. Brooks, Peter R. Carroll, Martin E. Gleave, Raymond S. Lance, Peter S. Nelson, Ian M. Thompson, Andrew A. Wagner, John T. Wei, Hui-Yu Yang, and Daniel W. Lin Liam C. MacleodLiam C. Macleod More articles by this author , William J. EllisWilliam J. Ellis More articles by this author , Lisa F. NewcombLisa F. Newcomb More articles by this author , Yingye ZhengYingye Zheng More articles by this author , James D. BrooksJames D. Brooks More articles by this author , Peter R. CarrollPeter R. Carroll More articles by this author , Martin E. GleaveMartin E. Gleave More articles by this author , Raymond S. LanceRaymond S. Lance More articles by this author , Peter S. NelsonPeter S. Nelson More articles by this author , Ian M. ThompsonIan M. Thompson More articles by this author , Andrew A. WagnerAndrew A. Wagner More articles by this author , John T. WeiJohn T. Wei More articles by this author , Hui-Yu YangHui-Yu Yang More articles by this author , and Daniel W. LinDaniel W. Lin More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2239AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Active surveillance (AS) is gaining acceptance for men with low risk prostate cancer (PCa) to prevent over-treatment related morbidity. Variability exists regarding the timing of the confirmatory biopsy (CBx) after diagnostic biopsy (DBx) in AS protocols. We analyze the Prostate Cancer Active Surveillance (PASS) cohort, determining timing and rates of PCa adverse reclassification (henceforth called reclassification) on CBx. METHODS Men (N=422) with low risk PCA on AS were selected from the multicenter PASS cohort (1,067 screened). Criteria included enrollment within 1 year of DBx, receipt of CBx after enrollment, DBx with <34% cores involved and Gleason <=6. Median PSA at diagnosis was 4.8 (IQR 3.7-6.3ng/ml). Reclassification was defined by increasing to Gleason >=7 or to >=34% cores involved. The PASS protocol requires a CBx within the first 6-12 months of DBx. The time interval from DBx to CBx in tertiles was 0-8.8, 8.9-12.4 and > 12.5 months. For simplicity, rates of reclassification on CBx were calculated at <8, 8-13 and >13 months post-DBx. Multivariable logistic regression determined association between reclassification, CBx timing, and other clinical and pathologic parameters. RESULTS 90 men (21.3%) experienced reclassification on CBx. CBx was performed 11 months (median) after DBx (IQR 7.8-13.8). Rates of reclassification at <8, 8-13 and >13 months were 23.5% (28/199 CBx), 19.5% (34/174 CBx), and 21.7% (28/129 CBx), respectively (p=0.71). On multivariable analysis factors associated with reclassification were BMI and prostate volume. BMI (categorized as <30, 30.1-34.9 and 35+ kg/m2) was associated with increased odds of reclassification in those with BMI > 35 kg/m2 (OR 6.1 95% CI 2.0, 18.7) compared to those with BMI < 30 kg/m2. Moderate (30-60ml; OR 0.28 95% CI 0.14, 0.57) and large (60ml+; OR 0.14 95% CI 0.05, 0.40) prostate volume were associated with decreased odds of reclassification compared to volume <30ml. CONCLUSIONS In a cohort of low risk PCa patients on AS, reclassification rates on CBx were not statistically different regardless of timing of CBx. Furthermore, these rates are not trivial (21.3% overall). These data can be utilized in patient consultation for risk of occult adverse disease and when considering timing of CBx and initiation of AS. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e755 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Liam C. Macleod More articles by this author William J. Ellis More articles by this author Lisa F. Newcomb More articles by this author Yingye Zheng More articles by this author James D. Brooks More articles by this author Peter R. Carroll More articles by this author Martin E. Gleave More articles by this author Raymond S. Lance More articles by this author Peter S. Nelson More articles by this author Ian M. Thompson More articles by this author Andrew A. Wagner More articles by this author John T. Wei More articles by this author Hui-Yu Yang More articles by this author Daniel W. Lin More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...