Immediate versus delayed prostatectomy and the fate of patients who progress to a higher risk disease on active surveillance

Oncological outcomes of radical prostatectomy (RP) in patients progressing on active surveillance (AS) are debated. We compared outcomes of AS eligible patients undergoing RP immediately after diagnosis with those doing so after delay or disease progression on AS. Between 2000 and 2014, 961 patients...

Full description

Saved in:
Bibliographic Details
Published in:Actas urológicas españolas (English ed.) 2019-07, Vol.43 (6), p.324-330
Main Authors: Mallya, A., Senguttuvan-Karthikeyan, V., Sivaraman, A., Barret, E., Galiano, M., Cathala, N., Mombet, A., Prapotnich, D., Sanchez-Salas, R., Cathelineau, X.
Format: Article
Language:English
Subjects:
Active surveillance
Cáncer de próstata
Delayed prostatectomy
Immediate prostatectomy
Progresión
Progression
Prostate cancer
Prostatectomía radical inmediata
Prostatectomía radical tardía
Vigilancia activa
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Oncological outcomes of radical prostatectomy (RP) in patients progressing on active surveillance (AS) are debated. We compared outcomes of AS eligible patients undergoing RP immediately after diagnosis with those doing so after delay or disease progression on AS. Between 2000 and 2014, 961 patients were AS eligible as per EAU criteria. RP within 6 months of diagnosis (IRP) or beyond (DRP), RP without AS (DRPa) and AS patients progressing to RP (DRPb) were compared. Baseline PSA, clinical and biopsy characteristics were noted. Oncological outcomes included adverse pathology in RP specimen and biochemical recurrence (BCR). Matched pair analysis was done between DRPb and GS7 patients undergoing immediate RP (GS7IRP). IRP, DRP, DRPa and DRPb had 820 (85%), 141 (15%), 118 (12.24%) and 23 (2.7%) patients respectively. IRP, DRPa and DRPb underwent RP at a median of 3, 9 and 19 months after diagnosis respectively. Baseline characteristics were comparable. DRP vs. IRP had earlier median time (31 vs. 43 months; p
ISSN:2173-5786
2173-5786
DOI:10.1016/j.acuroe.2019.05.003