Multicenter analysis of pathological outcomes of patients eligible for active surveillance according to PRIAS criteria.
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.
Clinica Urologica I, Universita` degli Studi di Milano, IRCCS Ca' Granda Foundation, Ospedale Maggiore Policlinic, Milan, Italy - angelica_grasso@yahoo.it.
Angelica A
AA
Grasso
Gabriele
G
Cozzi
Elisa
E
DE Lorenzis
Carlo
C
Ceruti
Simone
S
Crivellaro
Mario
M
Falsaperla
Andrea
A
Minervini
Lorenzo
L
Masieri
Angelo
A
Porreca
Stefano
S
Zaramella
Bernardo
B
Rocco
D000368:Aged; D001706:Biopsy; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D057832:Watchful Waiting