Please use this identifier to cite or link to this item: doi:10.22028/D291-37760
Title: Termination rates and histological reclassification of active surveillance patients with low- and early intermediate-risk prostate cancer : results of the PREFERE trial
Author(s): Albers, Peter
Wiegel, Thomas
Schmidberger, Heinz
Bussar-Maatz, Roswitha
Härter, Martin
Kristiansen, Glen
Martus, Peter
Meisner, Christoph
Wellek, Stefan
Grozinger, Klaus
Renner, Peter
Burmester, Martin
Schneider, Fried
Stöckle, Michael
Language: English
Title: World Journal of Urology
Volume: 39 (2021)
Issue: 1
Pages: 65–72
Publisher/Platform: Springer Nature
Year of Publication: 2020
Free key words: Active surveillance
Prostate cancer
Clinical trial
DDC notations: 610 Medicine and health
Publikation type: Journal Article
Abstract: Purpose Active surveillance (AS) strategies for patients with low- and early intermediate-risk prostate cancer are still not consistently defined. Within a controlled randomized trial, active surveillance was compared to other treatment options for patients with prostate cancer. Aim of this analysis was to report on termination rates of patients treated with AS including different grade groups. Methods A randomized trial comparing radical prostatectomy, active surveillance, external beam radiotherapy and brachytherapy was performed from 2013 to 2016 and included 345 patients with low- and early intermediate-risk prostate cancer (ISUP grade groups 1 and 2). The trial was prematurely stopped due to slow accrual. A total of 130 patients were treated with active surveillance. Among them, 42 patients were diagnosed with intermediate-risk PCA. Reference pathology and AS quality control were performed throughout. Results After a median follow-up time of 18.8 months, 73 out of the 130 patients (56%) terminated active surveillance. Of these, 56 (77%) patients were histologically reclassified at the time of rebiopsy, including 35% and 60% of the grade group 1 and 2 patients, respectively. No patients who underwent radical prostatectomy at the time of reclassification had radical prostatectomy specimens ≥ grade group 3. Conclusion In this prospectively analyzed subcohort of patients with AS and conventional staging within a randomized trial, the 2-year histological reclassification rates were higher than those previously reported. Active surveillance may not be based on conventional staging alone, and patients with grade group 2 cancers may be recommended for active surveillance in carefully controlled trials only.
DOI of the first publication: 10.1007/s00345-020-03154-7
URL of the first publication:
Link to this record: urn:nbn:de:bsz:291--ds-377605
ISSN: 1433-8726
Date of registration: 28-Oct-2022
Faculty: M - Medizinische Fakultät
Department: M - Urologie und Kinderurologie
Professorship: M - Prof. Dr. Michael Stöckle
Collections:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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