Gregory S Merrick1,2, Ava Tennant3, Ryan Fiano3, Abbey Bennett3, Richard Anderson3, Robert Galbreath3,4, Wayne M Butler3, Edward Adamovich5. 1. Schiffler Cancer Center, Wheeling Jesuit University, 1 Medical Park, Wheeling, WV, 26003, USA. gmerrick@urologicresearchinstitute.org. 2. Department of Urology, Wheeling Hospital, Wheeling, WV, 26003, USA. gmerrick@urologicresearchinstitute.org. 3. Schiffler Cancer Center, Wheeling Jesuit University, 1 Medical Park, Wheeling, WV, 26003, USA. 4. Ohio Univerisity Eastern, St. Clairsville, OH, 43950, USA. 5. Department Of Pathology, Wheeling Hospital, Wheeling, WV, 26003, USA.
Abstract
PURPOSE: To evaluate active surveillance (AS) outcomes including overall survival (OS), freedom from distant metastases (FDM), freedom from therapeutic intervention (FTI), and quality of life (QOL) outcomes in prostate cancer patients using transperineal template-guided mapping biopsy (TTMB) for patient selection. METHODS: From April 2005-January 2016, 226 consecutive, prospectively evaluated prostate cancer patients underwent TTMB for either low-grade prostate cancer or persistently elevated prostate-specific antigen (PSA) and/or the presence of ASAP. Evaluated outcomes included OS, FDM, FTI and QOL including urinary, bowel, sexual function and depression. Repeat biopsy was based on PSA kinetics and/or abnormal digital rectal examination. RESULTS: Of the 226 patients, 212 (93.8%) were Gleason 3 + 3 and 14 (6.2%) were Gleason 3 + 4. The median follow-up was 5.0 years (range 0.8-13.0 years). The mean prostate volume was 61.3 cm3 with a mean of 59.5 TTMB cores/patient. At the time of AS enrollment, an average of 72.9 cores (TRUS + TTMB) had been obtained for each patient. At 8 years, OS, FTI and FDM were 92.5, 96.8 and 100%. Two hundred and twenty-two patients (98.2%) had a PSA doubling time of more than 3 years. No statistical changes in urinary function, bowel function or depression were noted. At 8 years, 73% of the patients maintained erectile function. CONCLUSION: Within the confines of the follow-up of this study, the use of TTMB for patient selection identifies a cohort of patients unlikely to develop biochemical or clinical progression and maintain a favorable quality of life.
PURPOSE: To evaluate active surveillance (AS) outcomes including overall survival (OS), freedom from distant metastases (FDM), freedom from therapeutic intervention (FTI), and quality of life (QOL) outcomes in prostate cancerpatients using transperineal template-guided mapping biopsy (TTMB) for patient selection. METHODS: From April 2005-January 2016, 226 consecutive, prospectively evaluated prostate cancerpatients underwent TTMB for either low-grade prostate cancer or persistently elevated prostate-specific antigen (PSA) and/or the presence of ASAP. Evaluated outcomes included OS, FDM, FTI and QOL including urinary, bowel, sexual function and depression. Repeat biopsy was based on PSA kinetics and/or abnormal digital rectal examination. RESULTS: Of the 226 patients, 212 (93.8%) were Gleason 3 + 3 and 14 (6.2%) were Gleason 3 + 4. The median follow-up was 5.0 years (range 0.8-13.0 years). The mean prostate volume was 61.3 cm3 with a mean of 59.5 TTMB cores/patient. At the time of AS enrollment, an average of 72.9 cores (TRUS + TTMB) had been obtained for each patient. At 8 years, OS, FTI and FDM were 92.5, 96.8 and 100%. Two hundred and twenty-two patients (98.2%) had a PSA doubling time of more than 3 years. No statistical changes in urinary function, bowel function or depression were noted. At 8 years, 73% of the patients maintained erectile function. CONCLUSION: Within the confines of the follow-up of this study, the use of TTMB for patient selection identifies a cohort of patients unlikely to develop biochemical or clinical progression and maintain a favorable quality of life.
Authors: Gregory S Merrick; Gabe Rohmann; Robert Galbreath; Whitney Scholl; Ryan Fiano; Abbey Bennett; Wayne M Butler; Edward Adamovich Journal: BJUI Compass Date: 2020-11-29
Authors: Spyridon P Basourakos; Mark N Alshak; Patrick J Lewicki; Emily Cheng; Michael Tzeng; Antonio P DeRosa; Mathew J Allaway; Ashley E Ross; Edward M Schaeffer; Hiten D Patel; Jim C Hu; Michael A Gorin Journal: Eur Urol Open Sci Date: 2022-01-29