Conditional Probability of Reclassification in an Active Surveillance Program for Prostate Cancer

Published on Jun 1, 2015in The Journal of Urology5.925
· DOI :10.1016/J.JURO.2014.12.091
Ridwan Alam11
Estimated H-index: 11
(JHUSOM: Johns Hopkins University School of Medicine),
H. Ballentine Carter79
Estimated H-index: 79
(JHUSOM: Johns Hopkins University School of Medicine)
+ 2 AuthorsMufaddal Mamawala13
Estimated H-index: 13
(JHUSOM: Johns Hopkins University School of Medicine)
Purpose: We evaluated the risk of prostate cancer reclassification by time on active surveillance.Materials and Methods: From 1995 to 2014 we evaluated 557 and 251 men at very low and at low risk, respectively, who were on active surveillance and compliant with prostate biopsies. Our primary study outcome was reclassification to higher risk disease by grade or extent. Freedom from reclassification was estimated using the Kaplan-Meier approach with adjustment for covariates using the Cox proportional hazards model.Results: Within the first 2 years of surveillance patient survival free of reclassification by grade (p = 0.20) and by any biopsy criteria (p = 0.25) was similar in men with very low and low risk disease. After 2 years men with low risk disease were 2.4 times more likely to be diagnosed with a Gleason score of greater than 6 than men with very low risk disease (p = 0.002, HR 2.4, 95% CI 1.9–3.5). Additionally, beyond 2 years on surveillance the risk of lifetime reclassification by grade and by an...
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