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Disorders of the Male Reproductive System01:20

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Men's health issues are increasingly recognized as significant, with several conditions posing common threats. Among these, testicular cancer is especially prevalent in younger men, particularly those aged 20 to 35 years. The disease often manifests as a painless mass in the testicles, sometimes accompanied by a sensation of heaviness or a dull ache.
Prostate disorders are another major concern. These conditions can impair urinary flow due to the prostate's location around the urethra....
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Active Surveillance for Taiwanese Men with Localized Prostate Cancer: Intermediate-Term Outcomes and Predictive

Jian-Hua Hong1, Ming-Chieh Kuo1,2, Yung-Ting Cheng3

  • 1Department of Urology, National Taiwan University Hospital, Taipei, Taiwan.

The World Journal of Men'S Health
|October 19, 2023
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Summary

Active surveillance (AS) is a viable management option for low-risk prostate cancer (PC) in Taiwanese men. Higher prostate-specific antigen density (PSAD) predicts reclassification, while elevated PSAD, maximal percentage of cancer in positive cores (MPCPC), and Gleason grade group (GGG) predict conversion to active treatment.

Keywords:
Progression-free survivalProstate neoplasmsProstate-specific antigenWatchful waiting

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Area of Science:

  • Urology
  • Oncology
  • Prostate Cancer Management

Background:

  • Active surveillance (AS) is a key strategy for managing low-risk and select intermediate-risk prostate cancer (PC).
  • Predictive factors for disease reclassification and treatment conversion in Asian populations undergoing AS require further investigation.

Purpose of the Study:

  • To evaluate the intermediate-term outcomes of localized PC patients managed with AS in Taiwan.
  • To identify factors predicting disease reclassification and conversion to active treatment within this cohort.

Main Methods:

  • A cohort study of 405 men with localized non-high-risk PC in Taiwan (June 2012-Jan 2023).
  • Endpoints included pathological/radiographic reclassification and conversion to active treatment.
  • Cox proportional hazards models were used to analyze predictive factors.

Main Results:

  • The 5-year reclassification rates ranged from 18.6% to 27.0% across risk groups.
  • The 5-year conversion rates varied from 20.4% to 43.6%.
  • Elevated prostate-specific antigen density (PSAD ≥0.15 ng/mL²), maximal percentage of cancer in positive cores (MPCPC ≥15%), and Gleason grade group (GGG 3) were significant predictors of reclassification and/or conversion.

Conclusions:

  • Active surveillance is a feasible management option for Taiwanese men with non-high-risk PC.
  • High PSAD is a predictor for reclassification.
  • High PSAD, MPCPC, and GGG are predictors for conversion to active treatment.