title: Clinical Factors of Disease Reclassification or Progression in a Contemporary Cohort of Prostate Cancer Patients Elected to Active Surveillance.
abstract: OBJECTIVE
  To evaluate clinical predictors of disease reclassification or progression (DR/P) in prostate cancer patients elected to active surveillance (AS).
  
  
  METHODS
  Patients were assessed on the basis of DR/P criteria. Predictors of DR/P were evaluated by multivariate logistic regression and Cox proportional hazards.
  
  
  RESULTS
  The median DR/P free time was 16.5 months. DR/P was detected in 30 out of 84 cases (35.7%). In DR/P cases, the median prostate volume (PV) was significantly lower (34.7 vs. 42.7 ml) and the percentage of cases with 2 or 3 vs. 1 initial biopsy positive cores (BPC) was significantly higher (36.7 vs. 7.4%). The multivariate logistic regression model showed that PV (OR 0.9; p = 0.021) and initial n >1 BPC (OR 9.8; p = 0.001) were independent predictors of DR/P. By Cox multivariate proportional hazards, only n >1 BPC predicted early DR/P (hazard ratio 3.1; p = 0.003).
  
  
  CONCLUSIONS
  In a contemporary cohort of patients elected to AS, independent factors stratifying the risk of DR/P were PV and initial BPC, which also predicted early DR/P. In patients elected to AS, the identification of risk factors of DR/P require early re-biopsy. Confirmatory studies are required.
authors: Urologic Clinic, Ospedale Policlinico, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
authors: Antonio Benito
authors: AB
authors: Porcaro
authors: Francesca
authors: F
authors: Cavicchioli
authors: Daniele
authors: D
authors: Mattevi
authors: Nicolò
authors: N
authors: De Luyk
authors: Paolo
authors: P
authors: Corsi
authors: Marco
authors: M
authors: Sebben
authors: Alessandro
authors: A
authors: Tafuri
authors: Tania
authors: T
authors: Processali
authors: Mattia
authors: M
authors: Cerasuolo
authors: Irene
authors: I
authors: Tamanini
authors: Giovanni
authors: G
authors: Cacciamani
authors: Maria A
authors: MA
authors: Cerruto
authors: Matteo
authors: M
authors: Brunelli
authors: Giovanni
authors: G
authors: Novella
authors: Salvatore
authors: S
authors: Siracusano
authors: Walter
authors: W
authors: Artibani
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D062005:Biopsy, Large-Core Needle; D018450:Disease Progression; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011471:Prostatic Neoplasms / Q000145:classification* / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies; D057832:Watchful Waiting