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dc.contributor.authorVenkitaraman, R
dc.contributor.authorNorman, A
dc.contributor.authorWoode-Amissah, R
dc.contributor.authorFisher, C
dc.contributor.authorDearnaley, D
dc.contributor.authorHorwich, A
dc.contributor.authorHuddart, R
dc.contributor.authorKhoo, V
dc.contributor.authorThompson, A
dc.contributor.authorParker, C
dc.date.accessioned2018-07-26T13:43:22Z
dc.date.issued2007-09
dc.identifier.citationThe Journal of urology, 2007, 178 (3 Pt 1), pp. 833 - 837
dc.identifier.issn0022-5347
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/2169
dc.identifier.eissn1527-3792
dc.identifier.doi10.1016/j.juro.2007.05.038
dc.description.abstractActive surveillance for early prostate cancer is a policy of close monitoring with radical treatment targeted at cases with evidence of disease progression. There is no consensus on the need for or optimum timing of repeat biopsies as part of active surveillance.In a prospective cohort study of active surveillance 119 patients with untreated localized prostate cancer (T1/2a), prostate specific antigen less than 15 ng/ml, Gleason score 3 + 4 or less and 50% or less positive cores underwent repeat biopsy after 18 to 24 months. Histological disease progression was defined as primary Gleason grade 4 or greater, greater than 50% positive cores or a Gleason score increase from 6 or less to 7 or greater. The risk of histological disease progression was analyzed with respect to baseline clinical factors.Median patient age was 66 years and median initial prostate specific antigen was 6.6 ng/ml. Histological disease progression was seen in 33 of 119 cases (28%). On multivariate analysis prostate specific antigen density (p = 0.002) and maximum percent involvement of any core (p = 0.04) were significant independent determinants of histological disease progression. Progression was seen in 22 of 40 cases (55%) with prostate specific antigen density 0.2 ng/ml/ml or greater and greater than 15% maximum involvement of any core. Progression was seen in 2 of 33 cases (6%) with prostate specific antigen density less than 0.2 ng/ml/ml and 15% or less maximum involvement of any core.Repeat biopsy should be an integral part of active surveillance for untreated localized prostate cancer. Immediate repeat biopsy should be considered in patients who elect active surveillance but who have prostate specific antigen density greater than 0.2 ng/ml/ml. These findings must be validated in a cohort of patients with extended biopsies at diagnosis and followup.
dc.formatPrint-Electronic
dc.format.extent833 - 837
dc.languageeng
dc.language.isoeng
dc.subjectProstate
dc.subjectHumans
dc.subjectProstatic Neoplasms
dc.subjectDisease Progression
dc.subjectProstate-Specific Antigen
dc.subjectBiopsy, Needle
dc.subjectAged
dc.subjectMiddle Aged
dc.subjectMale
dc.titlePredictors of histological disease progression in untreated, localized prostate cancer.
dc.typeJournal Article
rioxxterms.versionofrecord10.1016/j.juro.2007.05.038
rioxxterms.licenseref.startdate2007-09
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfThe Journal of urology
pubs.issue3 Pt 1
pubs.notesNot known
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Closed research teams
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Closed research teams/Clinical Academic Radiotherapy (Dearnaley)
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Clinical Academic Radiotherapy (Huddart)
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Closed research teams
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Closed research teams/Clinical Academic Radiotherapy (Dearnaley)
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Clinical Academic Radiotherapy (Huddart)
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.publication-statusPublished
pubs.volume178
pubs.embargo.termsNot known
icr.researchteamClinical Academic Radiotherapy (Dearnaley)en_US
icr.researchteamClinical Academic Radiotherapy (Huddart)en_US
dc.contributor.icrauthorHorwich, Alanen
dc.contributor.icrauthorKhoo, Vincenten
dc.contributor.icrauthorDearnaley, Daviden
dc.contributor.icrauthorHuddart, Roberten
dc.contributor.icrauthorFisher, Cyrilen
dc.contributor.icrauthorParker, Chrisen


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