Uro today abstract on Active surveillance

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Regular Member

Date Joined Jan 2010
Total Posts : 363
   Posted 5/4/2011 5:27 PM (GMT -6)   
I get emails from Uro today, one caught my eye today and makes me rethink AS a bit. You have to sign up to see the text but I'll cut/paste the high points here.

Link for the guys who are/want to sign up


Most of the abstract for those who just want the meat.

The data of patients who underwent a radical prostatectomy at our institution between 1998 and 2010 were reviewed. We only included the patients that met the usual criteria for active surveillance: clinical stage T1-2a tumor, PSA ≤ 10ng/mL, biopsy Gleason sum inferior or equal to 6 with no pattern of grade 4 or 5, cancer involvement inferior or equal to two biopsy cores, inferior to 3mm of malignant tissue in each positive biopsy core. From them, only those who were diagnosed from a second line biopsies cores were included for further analysis.

Overall, 48 patient who met the "SURACAP" criteria had a laparoscopic radical prostatectomy at out institution. Mean age was 65.4 years. The mean preoperative PSA was 6.1ng/mL. Clinical stage of the tumor was T1c in 95% of patients and T2a in 5%. Biopsy Gleason score was 6(3+3) in 100%. Pathological analysis of the surgical specimen showed that 19% of patients had a seminal vesicle invasion or an extracapsular extension. The Gleason score of the pathological specimen was 6 (3 +3) in 57% of patients, 7 (3 +4) in 38% and 8 (4 +4) in 5% of patients. The Gleason score upgrading was 43% of patients.

In our experience, 19% of patients who meet the criteria for active surveillance show an extracapsular extension or a seminal vesicle invasion on pathological analysis. Active surveillance is still under evaluation.

I never was even close to AS but for someone thinking of it, WOW.
Dave in Durango CO

07-06 PSA 2.5
01-08 PSA 5.5 (Dr never told me)
09-09 PSA 6.5 (age 55)
12-09 Biopsy, initial Gleason 9 (4+5) later reduced to 8 with tertiary 5
03-01-10 Age 55 RRP in Durango CO by Dr Sejal Quale and Dr Shandra Wilson
03-16-10 Path' G-8 (4+4+5) Bilateral involving 21% of left lobe, 3% of right lobe, SVI, Focal positive margin, pT3b NO MX

All PSA as of 5-03-11 <0.04

Veteran Member

Date Joined Feb 2010
Total Posts : 3987
   Posted 5/4/2011 6:47 PM (GMT -6)   
the number of guys who are upgraded here tells me that AS wouldn't work for me. 
age: 56
PSA on 12/09: 6.8
gleason 3+4 = 7
received 3rd and last lupron shot 9/14/10
2/8/11 PSA <.1, T= 6 ng/dl

Cajun Jeff
Veteran Member

Date Joined Mar 2009
Total Posts : 4119
   Posted 5/4/2011 6:57 PM (GMT -6)   
Some guys have been very successful with AS but you have to be willing to take the risk and have the guts for it. I was too big a chicken for that. Had to have it out.

Cajun jeff
9/08 PSA 5.4 referred to Urologist
9/08 Biopsy: GS 3+4=7 1 positive core in 12 1% cancer core
10/08 Nerve-Sparing open radicalSurgery Path Report Downgrade 3+3=6 GS Stage pT2c margins clea
r3 month: PSA <0.1
19th month: PSA <0.1
2 year PSA <0.1
Only issue at this time is ED but getting better
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