Early Experience With Active Surveillance in Low-Risk Prostate Cancer Treated
하지용, 김병훈, 박철희, 김천일,
소속 상세정보
하지용 ( Ha Ji-Yong )
Keimyung University School of Medicine Department of Urology
김병훈 ( Kim Byung-Hoon )
Keimyung University School of Medicine Department of Urology
박철희 ( Park Choal-Hee )
Keimyung University School of Medicine Department of Urology
김천일 ( Kim Chun-Il )
Keimyung University School of Medicine Department of Urology
KMID : 0358320140550030167
Abstract
Purpose: This study was conducted to describe our early experience with active surveillance (AS).
Materials and Methods: Between January 2008 and December 2012, 35 patients were treated with AS. Selection criteria included the following: Gleason score ≤6 with single positive core, clinical stage ≤T1c, prostate-specific antigen (PSA) ≤10 ng/mL, and unremarkable imaging results. On patient follow-up, we regularly measured PSA (every 3-6 months) and performed prostate biopsies (after 1 and 3 years).
Results: In the first year of follow-up, prostate biopsies were performed in 25 patients (13 patients, negative for cancer; 7 patients, Gleason score of 6 without progression; 5 patients, progression, treated with radical prostatectomy [RP]). In the third year of follow-up, prostate biopsies were performed in five patients (two patients, negative for cancer; one patient, Gleason score of 6 without progression; two patients, progression, treated with RP). Seven patients discontinued AS because of increased anxiety, and three patients were lost to follow-up. Overall, seven patients (28%) who experienced progression had a mean PSA doubling time (DT) of 7.54 years. Six patients had a PSA DT of more than 3 years, whereas one had a PSA DT of less than 3 years. This study was limited by its small sample size and short follow-up period.
Conclusions: PSA kinetics did not correlate with progression, which suggests that regular biopsies should still be performed. AS is an available treatment option for patients with a low risk of prostate cancer but should only be used in carefully selected patients.
키워드
Needle biopsy; Prostate-specific antigen; Prostatic neoplasms; Watchful waiting
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