title: Pathological outcomes of men eligible for active surveillance after undergoing radical prostatectomy: are results predictable?
abstract: BACKGROUND
  To analyze pathological results in patients with prostate cancer eligible for active surveillance (AS) after radical prostatectomy and available prediction systems.
  
  
  METHODS
  A retrospective analysis was performed of 612 patients who underwent radical prostatectomy during a 14-year period. Subsequently, we selected those patients who would have been eligible for AS according to 2 different published criteria. Group AS-A matched the following criteria: ≤T2a; Gleason Score ≤6; and prostate-specific antigen <10 ng/mL, while group AS-B applied to different criteria: ≤T2a; Gleason Score <7; and prostate-specific antigen ≤15 ng/mL. Pathological outcomes were compared with results of the 2001 Partin tables.
  
  
  RESULTS
  Altogether, 125 (20.4%) patients were included in group AS-A and 159 (25.9%) in group AS-B. We detected 32 cases of >pT2c (25.6%) for group AS-A and 47 cases (29.6%) for AS-B, respectively. Gleason score upgrading was recorded in 34.4% (AS-A) and 38.3% (AS-B). Results of the Partin tables showed good discrimination among patients at risk for positive lymph nodes but limited discrimination for organ-confined disease, seminal vesicle.
  
  
  CONCLUSIONS
  Overall >25% of patients eligible for AS showed either upstaging or Gleason score upgrading, which could not be measured with the examined predictive tools. Patients should be informed about the risks of inaccurate preoperative diagnostic.
authors: Department of Urology, University of Bonn, Bonn, Germany. turangb@gmx.de
authors: Turang Ed
authors: TE
authors: Behbahani
authors: Jörg
authors: J
authors: Ellinger
authors: Daniel Garcia
authors: DG
authors: Caratozzolo
authors: Stefan C
authors: SC
authors: Müller
mesh_terms: D000328:Adult; D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D049451:Nomograms; D011159:Population Surveillance; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology* / Q000601:surgery*; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D017430:Prostate-Specific Antigen