A Decade of Active Surveillance in the PRIAS Study: An Update and Evaluation of the Criteria Used to Recommend a Switch to Active Treatment.

@article{Bokhorst2016ADO,
  title={A Decade of Active Surveillance in the PRIAS Study: An Update and Evaluation of the Criteria Used to Recommend a Switch to Active Treatment.},
  author={Leonard P Bokhorst and Riccardo Valdagni and Antti S Rannikko and Yoshiyuki Kakehi and Tom Pickles and Chris H. Bangma and Monique J. Roobol},
  journal={European urology},
  year={2016},
  volume={70 6},
  pages={
          954-960
        }
}
BACKGROUND The Prostate Cancer Research International Active Surveillance (PRIAS) study was initiated a decade ago to study the most optimal selection and follow-up of men on active surveillance (AS). OBJECTIVE We report on 10 yr of follow-up of men on AS in the PRIAS study and evaluate if criteria used to recommend a switch to active treatment truly predict unfavorable outcome on subsequent radical prostatectomy (RP). DESIGN, SETTING, AND PARTICIPANTS Men with low-risk prostate cancer were… Expand
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References

SHOWING 1-10 OF 24 REFERENCES
Active surveillance for low-risk prostate cancer worldwide: the PRIAS study.
TLDR
The short-term data support AS as a feasible strategy to reduce overtreatment and the strongest predictors for reclassification and switching to deferred treatment were the number of positive cores compared with one core and PSA density. Expand
Compliance Rates with the Prostate Cancer Research International Active Surveillance (PRIAS) Protocol and Disease Reclassification in Noncompliers.
TLDR
Compliance with an active surveillance protocol for low-risk prostate cancer in a large active surveillance study was looked at and reluctance to undergo yearly biopsies because of fast rising prostate-specific antigen was observed, despite a higher risk of disease progression. Expand
Predictors of unfavourable repeat biopsy results in men participating in a prospective active surveillance program.
TLDR
Clinical features at baseline and during follow-up in the AS cohort are significantly associated with short-term reclassification to higher risk on repeat biopsy, which can potentially be used for risk stratification of men with PCa who are apparently at favourable risk. Expand
Prospective validation of active surveillance in prostate cancer: the PRIAS study.
TLDR
Because screening for PCa is frequently applied, the attention to this approach in this specific subgroup of men with PCa has increased, and there is a rising demand for an evidence-based approach, but unfortunately it is not yet available. Expand
Radical prostatectomy for low-risk prostate cancer following initial active surveillance: results from a prospective observational study.
TLDR
RP results in men initially followed on active surveillance for low-risk prostate cancer show organ-confined disease and favourable Gleason grading in a majority of cases, and a main focus for AS protocols should be to improve the selection of patients at the time of inclusion to minimise reclassification of risk. Expand
Long-term follow-up of a large active surveillance cohort of patients with prostate cancer.
  • L. Klotz, D. Vesprini, +6 authors A. Loblaw
  • Medicine
  • Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2015
TLDR
Active surveillance for favorable-risk prostate cancer is feasible and seems safe in the 15-year time frame and the mortality rate is consistent with expected mortality in favorable- risk patients managed with initial definitive intervention. Expand
Active surveillance for prostate cancer: a systematic review of clinicopathologic variables and biomarkers for risk stratification.
TLDR
Primary data on markers, genetic factors, and risk stratification for patient selection and predictors of progression during active surveillance are reviewed to review a growing body of literature on patient characteristics, biopsy features, and biomarkers with potential utility in AS. Expand
The Evolution of Active Surveillance for Prostate Cancer.
TLDR
Multiparametric magnetic resonance imaging (mpMRI) is certainly less invasive than TRUS biopsy and might also provide a more accurate assessment of disease progression, and incorporation of mpMRI into active surveillance protocols could both safely reduce the need for repeatBiopsy and improve the accuracy of the biopsies that are performed. Expand
Precision Medicine in Active Surveillance for Prostate Cancer: Development of the Canary-Early Detection Research Network Active Surveillance Biopsy Risk Calculator.
TLDR
A combination of readily available clinical measures can stratify patients considering AS prostate biopsy and risk of progression or upgrade can be estimated and incorporated into clinical practice. Expand
Extended followup and risk factors for disease reclassification in a large active surveillance cohort for localized prostate cancer.
TLDR
Significant prostate cancer related morbidity and mortality remained rare at intermediate followup and prostate specific antigen density was independently associated with biopsy reclassification and treatment while on active surveillance. Expand
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