Active surveillance of low-grade prostate cancer using the SurACaP Criteria: A multi-institutional series with a median follow-up of 10years.

Autor:	Leclercq L; Department of Urology, North Hospital, Aix-Marseille University, AP-HM, Marseille, France., Bastide C; Department of Urology, North Hospital, Aix-Marseille University, AP-HM, Marseille, France., Lechevallier E; Department of Urology, La Conception Hospital, Aix-Marseille University, AP-HM, Marseille, France., Walz J; Department of Onco-urology, Institut Paoli Calmette, Marseille, France., Charvet AL; Department of Urology, North Hospital, Aix-Marseille University, AP-HM, Marseille, France., Gondran-Tellier B; Department of Urology, La Conception Hospital, Aix-Marseille University, AP-HM, Marseille, France., Campagna J; Department of Urology, North Hospital, Aix-Marseille University, AP-HM, Marseille, France., Savoie PH; Department of Urology, Hôpital d'instruction des armées de Sainte Anne, Toulon, France., Long-Depaquit T; Department of Urology, Hôpital d'instruction des armées de Sainte Anne, Toulon, France., Daniel L; Department of Pathology, Timone Hospital, Aix Marseille University AP-HM, Marseille, France., Rossi D; Department of Urology, North Hospital, Aix-Marseille University, AP-HM, Marseille, France., Pignot G; Department of Onco-urology, Institut Paoli Calmette, Marseille, France., Baboudjian M; Department of Urology, North Hospital, Aix-Marseille University, AP-HM, Marseille, France. Electronic address: Michael.Baboudjian@outlook.fr.
Jazyk:	angličtina
Zdroj:	The French journal of urology [Fr J Urol] 2024 Mar; Vol. 34 (2), pp. 102571. Date of Electronic Publication: 2024 Feb 04.
DOI:	10.1016/j.fjurol.2024.102571
Abstrakt:	Purpose: To report on the oncological outcomes of active surveillance (AS) in low-grade prostate cancer (PCa) patients using the French SurACaP protocol, with a focus on long-term outcomes. Methods: This multicenter study recruited patients with low-grade PCa between 2007 and 2013 in four referral centers in France. The cohort included patients meeting the SurACaP inclusion criteria, i.e., aged ≤75years, with low-grade PCa (i.e., ISUP 1), clinical stage T1c/T2a, PSA ≤10ng/mL and ≤3 positive cores and tumor length ≤3mm per core. The SurACaP protocol included a digital rectal examination every six months, PSA level measurement every three months for the first two years after inclusion and twice a year thereafter, a confirmatory biopsy in the first year after inclusion, and then follow-up biopsy every two years or if disease progression was suspected. Multiparametric magnetic resonance imaging (mpMRI) was progressively included over the study period. Results: A total of 86 consecutive patients were included, with a median follow-up of 10.6 years. Only one patient developed metastases and died of PCa. The estimated rates of grade reclassification and treatment-free survival at 15 years were 53.4% and 21.2%, respectively. A negative mpMRI at baseline and a negative confirmatory biopsy were significantly associated with a lower risk of disease progression (P<0.05). Conclusions: AS using the French SurACaP protocol is a safe and valuable strategy for patients with low-risk PCa, with excellent oncological outcomes after more than 10 years' follow-up. Future studies are crucial to broaden the inclusion criteria and develop a personalized, risk based AS protocol with the aim of de-escalating follow-up examinations. Level of Evidence: Grade 4. (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)
Databáze:	MEDLINE
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