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Timing of Adverse Prostate Cancer Reclassification on First Surveillance Biopsy: Results from the Canary Prostate Cancer Active Surveillance Study

2016; Lippincott Williams & Wilkins; Volume: 197; Issue: 4 Linguagem: Inglês

10.1016/j.juro.2016.10.090

1527-3792

Liam C. Macleod, William J. Ellis, Lisa F. Newcomb, Yingye Zheng, James D. Brooks, Peter R. Carroll, Martin Gleave, Raymond S. Lance, Peter S. Nelson, Ian M. Thompson, Andrew A. Wagner, John T. Wei, Daniel W. Lin,

Bladder and Urothelial Cancer Treatments

No AccessJournal of UrologyAdult Urology1 Apr 2017Timing of Adverse Prostate Cancer Reclassification on First Surveillance Biopsy: Results from the Canary Prostate Cancer Active Surveillance Study Liam C. Macleod, William J. Ellis, Lisa F. Newcomb, Yingye Zheng, James D. Brooks, Peter R. Carroll, Martin E. Gleave, Raymond S. Lance, Peter S. Nelson, Ian M. Thompson, Andrew A. Wagner, John T. Wei, and Daniel W. Lin Liam C. MacleodLiam C. Macleod University of Washington School of Medicine, Seattle, Washington , William J. EllisWilliam J. Ellis University of Washington School of Medicine, Seattle, Washington Fred Hutchinson Cancer Research Center, Seattle, Washington , Lisa F. NewcombLisa F. Newcomb University of Washington School of Medicine, Seattle, Washington , Yingye ZhengYingye Zheng Fred Hutchinson Cancer Research Center, Seattle, Washington , James D. BrooksJames D. Brooks Department of Urology, Stanford University School of Medicine, Stanford, California , Peter R. CarrollPeter R. Carroll University of California-San Francisco School of Medicine, San Francisco, California , Martin E. GleaveMartin E. Gleave University of British Columbia, Vancouver, British Columbia, Canada , Raymond S. LanceRaymond S. Lance Eastern Virginia Medical School, Norfolk, Virginia , Peter S. NelsonPeter S. Nelson Fred Hutchinson Cancer Research Center, Seattle, Washington , Ian M. ThompsonIan M. Thompson University of Texas Health Sciences Center at San Antonio, San Antonio, Texas , Andrew A. WagnerAndrew A. Wagner Beth Deaconess Medical Center, Boston, Massachusetts , John T. WeiJohn T. Wei University of Michigan, Ann Arbor, Michigan , and Daniel W. LinDaniel W. Lin University of Washington School of Medicine, Seattle, Washington Seattle Puget Sound Health Care System, Veterans Affairs Hospital, Seattle, Washington Fred Hutchinson Cancer Research Center, Seattle, Washington View All Author Informationhttps://doi.org/10.1016/j.juro.2016.10.090AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: During active surveillance for localized prostate cancer, the timing of the first surveillance biopsy varies. We analyzed the Canary PASS (Prostate Cancer Active Surveillance Study) to determine biopsy timing influence on rates of prostate cancer adverse reclassification at the first active surveillance biopsy. Materials and Methods: Of 1,085 participants in PASS, 421 had fewer than 34% of cores involved with cancer and Gleason sum 6 or less, and thereafter underwent on-study active surveillance biopsy. Reclassification was defined as an increase in Gleason sum and/or 34% or more of cores with prostate cancer. First active surveillance biopsy reclassification rates were categorized as less than 8, 8 to 13 and greater than 13 months after diagnosis. Multivariable logistic regression determined association between reclassification and first biopsy timing. Results: Of 421 men, 89 (21.1%) experienced reclassification at the first active surveillance biopsy. Median time from prostate cancer diagnosis to first active surveillance biopsy was 11 months (IQR 7.8–13.8). Reclassification rates at less than 8, 8 to 13 and greater than 13 months were 24%, 19% and 22% (p = 0.65). On multivariable analysis, compared to men biopsied at less than 8 months the OR of reclassification at 8 to 13 and greater than 13 months were 0.88 (95% CI 0.5,1.6) and 0.95 (95% CI 0.5,1.9), respectively. Prostate specific antigen density 0.15 or greater (referent less than 0.15, OR 1.9, 95% CI 1.1, 4.1) and body mass index 35 kg/m2 or greater (referent less than 25 kg/m2, OR 2.4, 95% CI 1.1,5.7) were associated with increased odds of reclassification. Conclusions: Timing of the first active surveillance biopsy was not associated with increased adverse reclassification but prostate specific antigen density and body mass index were. In low risk patients on active surveillance, it may be reasonable to perform the first active surveillance biopsy at a later time, reducing the overall cost and morbidity of active surveillance. References 1 : 20-year outcomes following conservative management of clinically localized prostate cancer. JAMA2005; 293: 2095. Google Scholar 2 : Time trends and local variation in primary treatment of localized prostate cancer. J Clin Oncol2010; 28: 1117. Google Scholar 3 : National Comprehensive Cancer Network Guidelines in Oncology: Prostate Cancer. 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Google Scholar © 2017 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byWaisman Malaret A, Chang P, Newcomb L, Faino A, Zheng Y, Zhu K, McKenney J, Brooks J, Dash A, Ellis W, Filson C, Gleave M, Liss M, Martin F, Morgan T, Carroll P, Nelson P, Lin D and Wagner A (2021) Effect of Diagnostic Biopsy Practice Location on Grade/Volume Reclassification in Active Surveillance for Prostate Cancer: A Multicenter Analysis from the Canary PASS CohortUrology Practice, VOL. 8, NO. 5, (576-582), Online publication date: 1-Sep-2021.Taneja S (2018) Re: Role of Surveillance Biopsy with no Cancer as a Prognostic Marker for Reclassification: Results from the Canary Prostate Active Surveillance StudyJournal of Urology, VOL. 200, NO. 1, (30-30), Online publication date: 1-Jul-2018.Taneja S (2018) Re: Comparative Analysis of Biopsy Upgrading in Four Prostate Cancer Active Surveillance CohortsJournal of Urology, VOL. 199, NO. 5, (1112-1113), Online publication date: 1-May-2018.Sanda M, Cadeddu J, Kirkby E, Chen R, Crispino T, Fontanarosa J, Freedland S, Greene K, Klotz L, Makarov D, Nelson J, Rodrigues G, Sandler H, Taplin M and Treadwell J (2018) Clinically Localized Prostate Cancer: AUA/ASTRO/SUO Guideline. Part II: Recommended Approaches and Details of Specific Care OptionsJournal of Urology, VOL. 199, NO. 4, (990-997), Online publication date: 1-Apr-2018.Sanda M, Cadeddu J, Kirkby E, Chen R, Crispino T, Fontanarosa J, Freedland S, Greene K, Klotz L, Makarov D, Nelson J, Rodrigues G, Sandler H, Taplin M and Treadwell J (2017) Clinically Localized Prostate Cancer: AUA/ASTRO/SUO Guideline. Part I: Risk Stratification, Shared Decision Making, and Care OptionsJournal of Urology, VOL. 199, NO. 3, (683-690), Online publication date: 1-Mar-2018.Loeb S (2017) When is a Negative Prostate Biopsy Really Negative? Repeat Biopsies in Detection and Active SurveillanceJournal of Urology, VOL. 197, NO. 4, (973-974), Online publication date: 1-Apr-2017.Smith J (2016) This Month in Adult UrologyJournal of Urology, VOL. 197, NO. 4, (969-970), Online publication date: 1-Apr-2017. Volume 197Issue 4April 2017Page: 1026-1033 Advertisement Copyright & Permissions© 2017 by American Urological Association Education and Research, Inc.Keywordswatchful waitingprostatic neoplasmsbiopsybody mass indexprostate specific antigenMetricsAuthor Information Liam C. Macleod University of Washington School of Medicine, Seattle, Washington More articles by this author William J. Ellis University of Washington School of Medicine, Seattle, Washington Fred Hutchinson Cancer Research Center, Seattle, Washington More articles by this author Lisa F. Newcomb University of Washington School of Medicine, Seattle, Washington More articles by this author Yingye Zheng Fred Hutchinson Cancer Research Center, Seattle, Washington More articles by this author James D. Brooks Department of Urology, Stanford University School of Medicine, Stanford, California More articles by this author Peter R. Carroll University of California-San Francisco School of Medicine, San Francisco, California More articles by this author Martin E. Gleave University of British Columbia, Vancouver, British Columbia, Canada More articles by this author Raymond S. Lance Eastern Virginia Medical School, Norfolk, Virginia More articles by this author Peter S. Nelson Fred Hutchinson Cancer Research Center, Seattle, Washington More articles by this author Ian M. Thompson University of Texas Health Sciences Center at San Antonio, San Antonio, Texas More articles by this author Andrew A. Wagner Beth Deaconess Medical Center, Boston, Massachusetts More articles by this author John T. Wei University of Michigan, Ann Arbor, Michigan More articles by this author Daniel W. Lin University of Washington School of Medicine, Seattle, Washington Seattle Puget Sound Health Care System, Veterans Affairs Hospital, Seattle, Washington Fred Hutchinson Cancer Research Center, Seattle, Washington More articles by this author Expand All Advertisement PDF downloadLoading ...