KEY TAKEAWAYS
- The study aimed to investigate the efficacy of AS in managing intermediate-risk in patients with PCa and its impact on long-term oncological outcomes.
- Researchers noticed that selective criteria in AS for favorable GG2 PCa lead to reduced reclassification risk and favorable long-term oncological outcomes, enhancing management protocols.
Pietro Pepe and the team aimed to evaluate the long-term oncological outcomes in men with intermediate-risk prostate cancer (PCa) enrolled in active surveillance (AS).
Researchers performed an inclusive analysis encompassing 30 men diagnosed with Gleason score 3+4/ISUP Grade Group 2 (GG2) prostate cancer, meeting specific criteria for enrollment in active surveillance (AS) from April 2015 to December 2022. All participants underwent confirmatory transperineal saturation biopsy (SPBx: 20 cores) 12 months post-diagnosis, complemented by multiparametric magnetic resonance imaging (mpMRI) evaluation.
Additionally, 68Ga prostate-specific membrane antigen (PSMA) positron-emission tomography (PET)/computed tomography (CT) was integrated into the assessment at the last follow-up, with lesions exhibiting a PIRADS score ≥3 and/or standardized uptake value (SUVmax) >5 subjected to four targeted cores for further evaluation.
About 10% (3/30) of men with GG2 PCa were reclassified at confirmatory biopsy. At the last follow-up (median 5.2 years), only 2 of 27 (7.4%) were reclassified, and 76.6% (23/30) continued AS.
The study concluded that men with favorable GG2 PCa enrolled in AS demonstrate promising long-term oncological outcomes. The utilization of selective criteria, including SPBx, mpMRI, and PSMA PET/CT, significantly decreases the risk of reclassification, highlighting the effectiveness of these modalities in optimizing patient management within AS protocols.
The study was sponsored by the International Institute of Anticancer Research.
Source: https://pubmed.ncbi.nlm.nih.gov/38688647/
Pepe P, Pepe L, Pennisi M, et al. (2024). “Oncological Outcomes in Men With Favorable Intermediate Risk Prostate Cancer Enrolled in Active Surveillance.” In Vivo. 2024 May-Jun;38(3):1300-1305. doi: 10.21873/invivo.13569. PMID: 38688647.
