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Active surveillance for prostate cancer: comparison of PRIAS-eligible and PRIAS-ineligible patients

Tijdschrift voor Urologie, ISSN: 2211-4718, Vol: 10, Issue: 1, Page: 9-16
2020
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Article Description

Little is known about the outcomes of off-protocol selected prostate cancer patients who opt for active surveillance. In our cohort of 1,000 patients, outcomes of PRIAS-eligible patients were compared with outcomes of PRIAS-ineligible patients. Unfavourable outcomes after radical prostatectomy (RP) and risk of metastasis were evaluated. 50% of patients on AS did not comply with the PRIAS criteria. PRIAS-ineligible patients discontinued active surveillance due to tumour progression significantly earlier than PRIAS-eligible patients; they also had a higher risk of positive surgical margins and unfavourable histology after deferred RP. PSA density ≥ 0.2 was the most important individual predictor and, in addition to a higher risk of tumour progression and unfavourable surgical outcomes, was also associated with a significantly higher risk of biochemical progression after deferred radical prostatectomy and a higher risk of metastasis.

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