The outcome of radical prostatectomy following active surveillance: a case control study

1. No. 093 The outcome of radical prostatectomy following active surveillance: a case control study Ahmed Eldefrawy, Mark S. Soloway, David Pan, RamgopalSatyanarayana, MurugesanManoharan Department of Urology, University of Miami, Miami, Florida, USA Posters Proudly Supported by: Introduction Active surveillance (AS) with delayed intervention is a well-established management alternative for men with low-risk prostate cancer (LRPC). Results A total of seventy patients were included in the study. Thirty five men had RP immediately after diagnosis and the other 35 were initially managed by AS. When the time factor was incorporated by the Kaplan Meier analysis, there was a significant difference in BCR between the 2 groups. Patients who were managed initially by AS had BCR earlier than those who underwent RP immediately after diagnosis (p= 0.031). Aim To compare the outcome of men who initially managed by AS before undergoing radical prostatectomy (RP) to those who underwent RP immediately after diagnosis. Methods Patients who initially managed by AS for LRPC and later underwent RPwere identified retrospectively. AS criteria are; prostate specific antigen (PSA) of ≤15.0 ng/dl, Gleason score ≤ 6, ≤ 2 positive core and no more than 20% tumor involvement in any of the cores. Treatment was triggered by not meeting AS criteria or patients’ preference. Similar number of matched patients from our RP database who met the criteria for AS and underwent RP immediately after diagnosis. The 2 groups were compared. Chi square test was used to compare categorical variable. Independent sample t test compared continuous variables. Kaplan Meier survival analysis described the biochemical recurrence (BCR) free survival between the 2 groups. Conclusions Although AS is a reasonable alternative to treatment for LRPC, the delayed intervention can increase the risk of having higher tumor volume, Gleason grade, and may result in earlier BCR. References Active surveillance: a reasonable management alternative for patients with prostate cancer, the Miami Experience, SolowayMS, Soloway CT, Williams S, et al BJU Int. 2008 Jan;101(2):165-9. The current status of active surveillance for prostate cancer. Pan DL, Samavedi S, Eldefrawy A, Manoharan M. Postgrad Med. 2012 May;124(3):50-8