The Active Surveillance for Low-risk Prostate Cancer: Case Series of Single Center

Abstract

Objective: Up to 80% of prostate cancer cases are indolentthat pose a minimal risk for morbidity and mortality throughoutthe life of the patient. Cancer-specific survival of the patients justfollowed up and those who received curative treatment were found tobe similar, especially in the low-risk category. Active surveillance wasdescribed to preserve the quality of life of the patients and to protectthem from the side effects of curative treatments. It has become increasinglyused in low and very low risk. Although there are manystudies on this subject with a large number of patients in the literature,we aimed to present our first results in this study. Material andMethods: The data of the patients, that were included in the activesurveillance program between January 2012 and April 2020, were retrospectivelyanalyzed. The patients were diagnosed with low-riskprostate cancer according to D’Amico criteria (International Societyof Urological Pathology grade group 1, prostate-specific antigen <10ng/mL, stage cT1c-T2a) via a minimum 12 core transrectal ultrasoundguided prostate biopsy due to suspicious digital rectal examinationand/or prostate-specific antigen elevation. Results: Thirty-six patients,who preferred active surveillance were included in the study.The mean age and prostate-specific antigen values of the patients were66.38±8.02 years and 5.63±2.3 ng/mL, respectively. The median follow-up was 18.4 (minimum 1.63-maximum 82.4) months. In the initialbiopsy, the cancer was detected in one core in 25 (69.4%), twocores in 10 (27.8%), and three cores in one (2.8%) of the patients. Atotal of 7 (19.4%) cases had received curative treatment. 3 cases hadprogression in pathological parameters and 4 cases chose to have activetreatment. Conclusion: Our initial results with active surveillanceare similar to the literature. Per the literature, the number ofpatients that chose active surveillance has increased.