Prostate Cancer :: Baseline characteristics and predictors of progression of prostate cancer

Active surveillance with delayed intervention is a viable option for well-selected patients with favorable risk prostate cancer.

But is there a single characteristic that could help determine which of these patients are likely to progress” What is the best predictor of subsequent intervention with treatment” To determine the best predictor of secondary treatment, researchers from the University of California, San Francisco (UCSF), examined demographic and clinical characteristics of men electing active surveillance.

The researchers led by Peter R. Carroll, M.D., characterized disease progression in a subset of men with low-risk disease enrolled in an active surveillance protocol at UCSF. Patients received repeat prostate needle biopsies at 12-24 month intervals, trans-rectal ultrasound (TRUS) every 6-12 months and PSA measurements every three months to track progression. Researchers defined progression as a change in PSA of greater than 0.75 ng/ml per year, increase in lesion size (as determined by TRUS) or change in Gleason sum. Of those three predictors, change in tumor grade was the most significant predictor of delayed intervention, with 35 percent of the subjects experiencing an increase in Gleason score on surveillance. There were no baseline demographic or clinical characteristics that could accurately predict disease progression in this population.


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