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Minerva Urologica e Nefrologica 2016 June;68(3):237-41


language: English

Multicenter analysis of pathological outcomes of patients eligible for active surveillance according to PRIAS criteria

Angelica A. GRASSO 1, Gabriele COZZI 1, Elisa DE LORENZIS 1, Carlo CERUTI 2, Simone CRIVELLARO 3, Mario FALSAPERLA 4, Andrea MINERVINI 5, Lorenzo MASIERI 5, Angelo PORRECA 6, Stefano ZARAMELLA 7, Bernardo ROCCO 1

1 Clinica Urologica I, Universita` degli Studi di Milano, IRCCS Ca’ Granda Foundation, Ospedale Maggiore Policlinic, Milan, Italy; 2 Clinica Urologica della Città della Salute e della Scienza di Torino, Turin, Italy; 3 Department of Urology, University Hospital of Udine, Udine, Italy; 4 Department of Urology, Policlinico Vittorio Emanuele II di Catania, Catania, Italy; 5 Department of Urology, Università degli studi di Firenze, Careggi Hospital, Florence, Italy; 6 Department of Urology, Abano Terme Policlinic, Abano Terme, Padova, Italy; 7 Department of Urology, Azienda Ospedaliera Universitaria Maggiore della Carità, Novara, Italy


BACKGROUND: The aim of this study was to retrospectively analyze the pathological outcomes of patients meeting the Prostate Cancer Research International Active Surveillance (PRIAS) criteria who had undergone radical prostatectomy (RP).
METHODS: Out of 2014 patients recruited for minimally invasive RP between 2008 and 2014 in 7 centers, 226 (11.2%) met the modified PRIAS criteria (clinical stage T1c/T2, PSA<10 ng/mL, 1-2 positive biopsy cores and Gleason Score<6).
RESULTS: At pathological evaluation, Gleason Score upgrade was reported in 47.3% of patients; 74 (32.7%), 10 (4.4%), 9 (3.9%) patients showed RP Gleason sum 7, 8 and 9, respectively. Upstaging was reported in 135 patients (59.7%). Twelve (5.3%) and 4 (1.7%) patients had T3a and T3b pathological stage respectively.
CONCLUSIONS: Notwithstanding the PRIAS criteria can identify some PCa patients as low-risk, at pathological evaluation some of them harbored intermediate- or high-risk disease. According to our data, patients eligible for AS should be carefully counseled about possible disease understaging.

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