title: Clinical Factors Predicting Tumour Upgrading in Patients Under Active Surveillance and Elected to Active Treatment after Disease Reclassification or Progression.
abstract: OBJECTIVE
  To evaluate clinical factors associated with tumour upgrading (UPG) in low-intermediate risk patients who progressed while under active surveillance (AS) and underwent delayed radical prostatectomy.
  
  
  METHODS
  The evaluated factors included prostate specific antigen (PSA), prostate volume, PSA density and number of biopsy positive cores (BPC). Multivariate logistic regression by the forward step Wald procedure was used.
  
  
  RESULTS
  The study evaluated 24 patients who had UPG in 13 cases (54.2%). Independent factors associated with tumour UPG included PSA (OR 2.1; p = 0.047) and BPC (OR 2; p = 0.042).
  
  
  CONCLUSIONS
  Clinical factors associated with UPG were identified in patients who were under AS for with low-intermediate risk disease. Preoperative PSA levels and number of BPC were independent factors associated with UPG in a contemporary cohort of patients who progressed under AS and underwent delayed active treatment.
authors.affiliation: Urologic Clinic, University Hospital, Ospedale Policlinico, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
authors.forename: Antonio Benito
authors.initials: AB
authors.lastname: Porcaro
authors.forename: Francesca
authors.initials: F
authors.lastname: Cavicchioli
authors.forename: Nicolò
authors.initials: N
authors.lastname: De Luyk
authors.forename: Daniele
authors.initials: D
authors.lastname: Mattevi
authors.forename: Paolo
authors.initials: P
authors.lastname: Corsi
authors.forename: Marco
authors.initials: M
authors.lastname: Sebben
authors.forename: Alessandro
authors.initials: A
authors.lastname: Tafuri
authors.forename: Tania
authors.initials: T
authors.lastname: Processali
authors.forename: Davide
authors.initials: D
authors.lastname: Inverardi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cacciamani
authors.forename: Davide
authors.initials: D
authors.lastname: De Marchi
authors.forename: Matteo
authors.initials: M
authors.lastname: Balzarro
authors.forename: Maria A
authors.initials: MA
authors.lastname: Cerruto
authors.forename: Matteo
authors.initials: M
authors.lastname: Brunelli
authors.forename: Giovanni
authors.initials: G
authors.lastname: Novella
authors.forename: Salvatore
authors.initials: S
authors.lastname: Siracusano
authors.forename: Walter
authors.initials: W
authors.lastname: Artibani
mesh_terms: D000368:Aged; D001706:Biopsy; D016009:Chi-Square Distribution; D018450:Disease Progression; D006801:Humans; D007610:Kallikreins / Q000097:blood; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D016017:Odds Ratio; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology* / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome; D057832:Watchful Waiting
chemical_list: C549870:KLK3 protein, human; D007610:Kallikreins; D017430:Prostate-Specific Antigen
keywords: Active surveillance; Active treatment; Disease progression; Low-risk; Prostate cancer; Radical prostatectomy; Tumour upgrading