Details

Autor(en) / Beteiligte

• Wetterauer, Christian
• Federer-Gsponer, Joel R.
• Leboutte, Francois D.J.P.
• Mona, Robin
• Ebbing, Jan
• Rentsch, Cyrill A.
• Manka, Lukas
• Seifert, Hans H.
• Wyler, Stephen
• Recker, Franz
• Kwiatkowski, Maciej

Titel

Indication for Active Surveillance in the Era of MRI-Targeted Prostate Biopsies

Ist Teil von

• Urologia internationalis, 2022-01, Vol.106 (1), p.83-89

Ort / Verlag

Basel, Switzerland: S. Karger AG

Erscheinungsjahr

2022

Quelle

MEDLINE

Beschreibungen/Notizen

• Introduction: Active surveillance (AS) strategies were established to avoid overtreatment of low-risk prostate cancer (PCa) patients. Low tumor volume represents one indication criteria; however, applying this criterion after MRI-targeted prostate biopsies may lead to overestimation of tumor volume; wherefore, patients suitable for AS would be exposed to the risk of overtreatment. Methods: This retrospective analysis included 318 patients in which PCa was detected by MRI-TRUS fusion prostate biopsy. Classic and extended indication for AS included Gleason 6 and Gleason 3 + 4 cancer, respectively. We assessed the effect of targeted biopsies and temporary rating strategies on eligibility for AS and developed new “composite” algorithms to more accurately assess eligibility for AS. Results: Forty-four (13.8%) and 60 (18.9%) of the 318 patients qualified for AS according to “classic” and “extended” criteria, respectively. Application of the “composite 1” definition led to AS eligibility of 52 of 248 patients (20.97%) in the classic and of 77 of 248 patients (31.05%) in the “extended” group. Conclusions: We could demonstrate that classic algorithms led to ineligibility of patients for AS. We propose a new rating algorithm to improve tumor assessment for a more accurate indication for AS.