You have accessJournal of UrologyProstate Cancer: Localized VII1 Apr 20121474 THE IMPACT OF UPGRADING IN PATIENTS CANDIADTES FOR ACTIVE SURVEILLANCE Francisco Comez-Veiga, Sara Breijo, Sonia Pertega, Anton Zarraonaindia, Javier Casas, Iyahd Barghouty, Luis Busto, Juan Dacal, Jose Ponce, Salvador Pita, and V. Ch. Abal Francisco Comez-VeigaFrancisco Comez-Veiga University Hospital a Coruña, Spain More articles by this author , Sara BreijoSara Breijo A Coruña, Spain More articles by this author , Sonia PertegaSonia Pertega A Coruña, Spain More articles by this author , Anton ZarraonaindiaAnton Zarraonaindia A Coruña, Spain More articles by this author , Javier CasasJavier Casas A Coruña, Spain More articles by this author , Iyahd BarghoutyIyahd Barghouty A Coruña, Spain More articles by this author , Luis BustoLuis Busto A Coruña, Spain More articles by this author , Juan DacalJuan Dacal A Coruña, Spain More articles by this author , Jose PonceJose Ponce A Coruña, Spain More articles by this author , Salvador PitaSalvador Pita A Coruña, Spain More articles by this author , and V. Ch. AbalV. Ch. Abal A Coruña, Spain More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1995AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Due to the migration of clinical stages now see a larger number of patients with low tumor burden increasingly we emphasize the need for active treatments with their associated side effects. The aim of this study is analyze the cancer outcomes and the impact of upgrading in a series of patients who are candidates for active monitoring using the PRIAS criteria (P) and those undergoing radical prostatectomy (RP) using the START (S) criteria. METHODS In the period between June 1999 and December 2008, 687 patients who no received neo-adjuvant or adjuvant treatment were included. Prostate cancer diagnosis was obtained by ultrasound-guided 10-core biopsy and PSA test, before rectal examination. We used the Gleason classification for clinical and pathological stage and TNM 2009 for clinical staging. We selected patients who met the criteria for AS as criteria P ‘PSA <10, PSADT ≤ 0.2, CT1, CT2, Gleason ≤ 6, ≤ 2 core positive biopsy', or S, ‘PSA <10, 0.05. Table. CONCLUSIONS A significant proportion of patients eligible for active follow-up in both studies may have adverse pathological findings, and high incidence of progression but the impact and over all progression appear not be significant. All these data indicate that the selection of candidates for active monitoring, pending the results of clinical trials has to be careful. We need new diagnostic tools that allow us to better define the aggressiveness of prostate tumors. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e597-e598 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Francisco Comez-Veiga University Hospital a Coruña, Spain More articles by this author Sara Breijo A Coruña, Spain More articles by this author Sonia Pertega A Coruña, Spain More articles by this author Anton Zarraonaindia A Coruña, Spain More articles by this author Javier Casas A Coruña, Spain More articles by this author Iyahd Barghouty A Coruña, Spain More articles by this author Luis Busto A Coruña, Spain More articles by this author Juan Dacal A Coruña, Spain More articles by this author Jose Ponce A Coruña, Spain More articles by this author Salvador Pita A Coruña, Spain More articles by this author V. Ch. Abal A Coruña, Spain More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

You have accessJournal of UrologyProstate Cancer: Detection and Screening1 Apr 20111196 MODELS TO PREDICT PROSTATE CANCER AGGRESSIVINESS IN PATIENTS CANDIDATES TO BIOPSY WITH PSA 2.5–10 F. Gomez Veiga, J. Ponce, S. Pertega, S. Breijo, J. Dacal, M. Torres, I. Rodriguez, D. Lopez, S. Pita, and V. Ch. Abal F. Gomez VeigaF. Gomez Veiga A Coruña, Spain More articles by this author , J. PonceJ. Ponce A Coruña, Spain More articles by this author , S. PertegaS. Pertega A Coruña, Spain More articles by this author , S. BreijoS. Breijo A Coruña, Spain More articles by this author , J. DacalJ. Dacal A Coruña, Spain More articles by this author , M. TorresM. Torres A Coruña, Spain More articles by this author , I. RodriguezI. Rodriguez A Coruña, Spain More articles by this author , D. LopezD. Lopez A Coruña, Spain More articles by this author , S. PitaS. Pita A Coruña, Spain More articles by this author , and V. Ch. AbalV. Ch. Abal A Coruña, Spain More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.831AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Prostate biopsy is the standard method to diagnose prostate cancer (PC). Some concern exists over possibility to diagnose a high percent of insignificant tumors and overtreatment. The aim of this study is develop clinical nomograms to predict, PC aggressiveness on patients with psa 2.5–10 ng/ml. METHODS Prospective study of 3098 patients with PSA 2.5-10 ng/mL, referred consecutively for first biopsy, between September 2002 and December 2009. A sample of PSA and Complex PSA (cPSA) (Centaur®) was taken previous to biopsy and rectal examination. The technique to biopsy in all patients was TRU guided, 10 core biopsies were obtained. Factors associated with the results of biopsy were studied, including: age,DRE,PSA,cPSA, %c-tPSA and PSA density. Multiple logistic regression was used to simultaneously assess the association of clinical characteristics with the results of the biopsy. Three different outcomes were considered: i) cancer, ii) high grade cancer (Gleason score ≥ 7) and iii) more than 2 positive cores in biopsy. Nomograms were constructed based on the fitted multiple logistic regression models with a bootstrap resampling approach. Statistical analyses were performed by using SPSS version 17.0. RESULTS Of the 3098 patients, 1045 (33.7%) were found to have PC at biopsy. Of these, 536 (51.3%) had a Gleason score ≥7, and 603 (57.7%) were found to have PC at biopsy in >2 cores. All studied risk factors were found to be significantly associated with PC detection in the univariate analysis. Multivariate analysis showed that older age at biopsy, abnormal digital rectal examination, higher values of cPSA, %c-tPSA and PSA density were significantly associated with a higher probability of diagnosing PC and aggressiviness in the biopsy. Three nomograms were constructed to predict the presence of: i) , ii) and iii). These nomograms predict biopsy outcomes with good discrimination (Bootstrap corrected AUC's 0.76, 0.81 and 0.78 for i,ii,iii respectively). CONCLUSIONS Three nomograms are proposed to predict the diagnosis of PC and aggressive forms of PC at prostate biopsy in the 2.5-10 ng/mL PSA range. These tools could help clinicians to assess PC risk on an individual basis and make management decisions. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e480 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information F. Gomez Veiga A Coruña, Spain More articles by this author J. Ponce A Coruña, Spain More articles by this author S. Pertega A Coruña, Spain More articles by this author S. Breijo A Coruña, Spain More articles by this author J. Dacal A Coruña, Spain More articles by this author M. Torres A Coruña, Spain More articles by this author I. Rodriguez A Coruña, Spain More articles by this author D. Lopez A Coruña, Spain More articles by this author S. Pita A Coruña, Spain More articles by this author V. Ch. Abal A Coruña, Spain More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...