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Microarray-based Identification of Individual HERV Loci Expression: Application to Biomarker Discovery in Prostate Cancer
Published on: November 2, 2013
Active surveillance in low risk prostate cancer: Role of multiparametric MRI and cancer progression predictors
Nasser Simforoosh1, Mehdi Dadpour1, Behzad Narouie2
1Shahid Labbafinejad Medical Center, The Center of Excellence in Urology, Urology and Nephrology Research Center, Research Institute for Urology and Nephrology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Introduction:
To evaluate the outcomes of active surveillance (AS) strategy for patients with favorable risk prostate cancer (PCa) and identify multiparametric MRI role and PCa progression predictors.
Method:
This was a 5-year follow-up cohort study which enrolled 153 favorable-risk PCa patients in an AS program from April 2017 to February 2023. Patients were included in this study based on AS protocol inclusion criteria. MpMRI was also a part of this protocol. Active surveillance outcomes such as adherence to AS treatment strategy and the oncologic outcomes were assessed.
Results:
During the 4.23 ± 0.5 years follow-up, 39 of 153 patients left the AS protocol by their own decision (14) or other physicians' advice, due to the concern of cancer progression; 5 of 153 died from another cause other than PCa; 9 of 153 revealed cancer progression during this time and underwent radical prostatectomy; The remaining 100 patients stayed on the AS protocol during the follow up. Adherence to AS strategy protocol was 60.55% in our study. Older age, positive family history for PCa, initial clinical stage, higher total PSA, greater PSA density, more positive cores, and greater core involvement were the most common predictors for progression. The sensitivity, specificity, positive predictive value, and negative predictive value of mpMRI for cancer progression detection were 55.55%, 97%, 62.25%, and 96%, respectively.
Conclusion:
AS can be a suitable alternative treatment for low-risk and very low risk prostate cancer to avoid the probable complications of radical prostatectomy. MpMRI is valid and reliable for identifying PCa progression and provides useful information when combined with biopsy.
Insights
Active surveillance (AS) is a viable option for favorable-risk prostate cancer (PCa), with multiparametric MRI (mpMRI) aiding in progression detection. Key predictors for progression include age and PSA density.
Area of Science:
- Urology
- Oncology
- Radiology
Background:
- Active surveillance (AS) is a management strategy for favorable-risk prostate cancer (PCa).
- Evaluating AS outcomes and the role of multiparametric MRI (mpMRI) in detecting PCa progression is crucial.
Purpose of the Study:
- To assess the outcomes of AS in patients with favorable-risk PCa.
- To determine the role of mpMRI in identifying PCa progression.
- To identify predictors of PCa progression during AS.
Main Methods:
- A 5-year follow-up cohort study of 153 favorable-risk PCa patients on an AS program.
- Inclusion based on AS protocol criteria, with mpMRI as part of the protocol.
- Assessment of AS adherence and oncologic outcomes.
Main Results:
- Adherence to AS was 60.55% over a mean follow-up of 4.23 years.
- Progression occurred in 9 patients, while 100 remained on AS.
- Predictors of progression included older age, family history, higher PSA density, and more positive biopsy cores.
- mpMRI showed 55.55% sensitivity and 97% specificity for detecting cancer progression.
Conclusions:
- AS is a suitable alternative to radical prostatectomy for low- and very low-risk PCa.
- mpMRI is reliable for detecting PCa progression, especially when combined with biopsy data.
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