Progression and treatment rates using an active surveillance protocol incorporating image-guided baseline biopsies and multiparametric magnetic resonance imaging monitoring for men with favourable-risk prostate cancer.
作者： David Thurtle , Tristan Barrett , Vineetha Thankappan-Nair , Brendan Koo , Anne Warren
DOI: 10.1111/BJU.14166
关键词:
摘要: OBJECTIVE To assess early outcomes since the introduction of an active surveillance (AS) protocol incorporating multiparametric magnetic resonance imaging (mpMRI)-guided baseline biopsies and image-based surveillance. PATIENTS AND METHODS A new AS mandating image-guided biopsies, annual mpMRI 3-monthly prostate-specific antigen (PSA) testing, but which retained re-biopsies, was tested. Pathological progression, treatment conversion triggers for non-protocol biopsy were recorded prospectively. RESULTS Data from 157 men enrolled in (median age 64 years, PSA 6.8 ng/mL, follow-up 39 months) interrogated. total 12 (7.6%) left programme by choice. Of 145 who remained, 104 had re-biopsies either triggered a rise level, change findings or protocol. Overall, 23 (15.9%) experienced disease progression; pathological changes observed 20 results three men. these men, 17 switched to treatment, giving rate 11.7% (<4% per year). with this detected four them after increase re-biopsy, while 10 progression change. Progression six however, solely re-biopsy without prior changes. Using alone detect found have sensitivity specificity 70.0% 81.7%, respectively. CONCLUSION Our protocol, thorough assessment imaging-based surveillance, showed low rates conversion. Changes principle trigger detecting pathologically; still significant number progressions
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