Impact of adherence to criteria on oncological outcomes of radical prostatectomy in patients opting for active surveillance: data from the PRIAS-JAPAN study

Yoichiro Tohi, Takuma Kato, Jimpei Miyakawa, Ryuji Matsumoto, Hiroshi Sasaki, Koji Mitsuzuka, Junichi Inokuchi, Masafumi Matsumura, Akira Yokomizo, Hidefumi Kinoshita, Isao Hara, Norihiko Kawamura, Kohei Hashimoto, Masaharu Inoue, Jun Teishima, Hidenori Kanno, Hiroshi Fukuhara, Satoru Maruyama, Shinichi Sakamoto, Toshihiro SaitoYoshiyuki Kakehi, Mikio Sugimoto

Research output: Contribution to journalArticlepeer-review

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Abstract

OBJECTIVES: This study aimed to evaluate whether oncological outcomes of radical prostatectomy differ depending on adherence to the criteria in patients who opt for active surveillance. MATERIALS AND METHODS: We retrospectively reviewed the data of 1035 patients enrolled in a prospective cohort of the PRIAS-JAPAN study. After applying the exclusion criteria, 136 of 162 patients were analyzed. Triggers for radical prostatectomy due to pathological reclassification on repeat biopsy were defined as on-criteria. Off-criteria triggers were defined as those other than on-criteria triggers. Unfavorable pathology on radical prostatectomy was defined as pathological ≥T3, ≥GS 4 + 3 and pathological N positivity. We compared the pathological findings on radical prostatectomy and prostate-specific antigen recurrence-free survival between the two groups. The off-criteria group included 35 patients (25.7%), half of whom received radical prostatectomy within 35 months. RESULTS: There were significant differences in median prostate-specific antigen before radical prostatectomy between the on-criteria and off-criteria groups (6.1 vs. 8.3 ng/ml, P = 0.007). The percentage of unfavorable pathologies on radical prostatectomy was lower in the off-criteria group than that in the on-criteria group (40.6 vs. 31.4%); however, the differences were not statistically significant (P = 0.421). No significant difference in prostate-specific antigen recurrence-free survival was observed between the groups during the postoperative follow-up period (median: 36 months) (log-rank P = 0.828). CONCLUSIONS: Half of the off-criteria patients underwent radical prostatectomy within 3 years of beginning active surveillance, and their pathological findings were not worse than those of the on-criteria patients.

Original languageEnglish
Pages (from-to)1056-1061
Number of pages6
JournalJapanese journal of clinical oncology
Volume52
Issue number9
DOIs
Publication statusPublished - Sep 18 2022
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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