The impact of complications after initial prostate biopsy on repeat protocol biopsy acceptance rate. Results from the Prostate Cancer Research International: Active Surveillance JAPAN study

e17616 Background: Active surveillance(AS) is the strategy to avoid the overtreatment for favorable prostate cancer. For safer AS protocol execution, repeat protocol biopsy is essential in evaluating cancer aggressiveness accurately. However, some men on AS refuse repeat protocol biopsy because of burdens on biopsy. We aimed to assess the complications of prostate biopsy and the impact of complications after diagnostic biopsy on repeat protocol biopsy from the analysis Japanese cohort forming part of the Prostate cancer Research International: Active surveillance (PRIAS) study. Methods: PRIAS-JAPAN started in January 2010, 39 institutions are participating in this study. Men are prospectively followed and repeat protocol biopsy are planned at 1 year and 4 years thereafter, or if prostate specific antigen-doubling time is < 10 years. Data was collected on the complications such as infection, hematuria, hematospermia, pain, and antibiotics, and approach of biopsy, retrospectively. We compared the complications in diagnostic biopsy between repeat biopsy acceptance group and repeat biopsy non-acceptance group at 1 year. Results: From 2010 to 2018, 862 men with low-risk prostate cancer were prospectively enrolled in PRIAS-JAPAN. 794 men (92%) actually proceeded to protocol at 1 year. Of the 794 men, repeat protocol biopsy non-acceptance rate at 1 year was 18.4%(146 men). According to differences in the complications of diagnostic biopsy, hematuria(p = 0.003) and pain(p < 0.001) rate were significantly higher in repeat biopsy non-acceptance group, but infection(p = 0.105) and hematospermia(p = 0.224). Approach of biopsy(p = 0.651) was not different in two groups. Conclusions: Hematuria and pain in diagnostic biopsy were significantly more frequent in repeat biopsy non-acceptance group. Our study supports the importance of adequate explanation and management of the complications at biopsy to improve the rate of protocol biopsy acceptance. [Table: see text]

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Eight year patient reported outcome data of the first 150 Dutch men on active surveillance in the Prostate cancer Research International Active Surveillance study (PRIAS)

European Urology Supplements ◽

10.1016/s1569-9056(19)31240-0 ◽

2019 ◽

Vol 18 (1) ◽

pp. e1707-e1708

Author(s):

L.D.F. Venderbos ◽

R.C.N. Van Den Bergh ◽

C.H. Bangma ◽

M.J. Roobol

Keyword(s):

Prostate Cancer ◽

Cancer Research ◽

Active Surveillance ◽

Patient Reported Outcome ◽

Outcome Data ◽

Surveillance Study ◽

Patient Reported ◽

Prostate Cancer Research

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Complications after prostate biopsies in men on active surveillance and its effects on receiving further biopsies in the Prostate cancer Research International: Active Surveillance (PRIAS) study

BJU International ◽

10.1111/bju.13410 ◽

2016 ◽

Vol 118 (3) ◽

pp. 366-371 ◽

Cited By ~ 26

Author(s):

Leonard P. Bokhorst ◽

Inari Lepistö ◽

Yoshiyuki Kakehi ◽

Chris H. Bangma ◽

Tom Pickles ◽

...

Keyword(s):

Prostate Cancer ◽

Cancer Research ◽

Active Surveillance ◽

Prostate Biopsies ◽

Prostate Cancer Research

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Outcomes of the patients with pT0 on first protocol biopsy during active surveillance for early prostate cancer: From the PRIAS-JAPAN study.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.7_suppl.20 ◽

2019 ◽

Vol 37 (7_suppl) ◽

pp. 20-20

Author(s):

Takuma Kato ◽

Mikio Sugimoto ◽

Yoshiyuki Kakehi ◽

Akito Yamaguchi ◽

Akira Yokomizo ◽

...

Keyword(s):

Prostate Cancer ◽

Active Surveillance ◽

Clinical Stage ◽

Protocol Biopsy ◽

Japanese Cohort ◽

Definitive Therapy ◽

Significant Difference ◽

Prostate Cancer Research ◽

Therapy Clinical Trial ◽

Clinical Trial Information

20 Background: We assessed the outcomes of the patients with pT0 on first protocol biopsy during active surveillance(AS) from the analysis Japanese cohort forming part of the Prostate Cancer Research International: Active Surveillance (PRIAS) study. Methods: PRIAS-JAPAN started in January 2010. 39 institutions are participating in this study. The inclusion criteria for the PRIAS study are as follows: clinical stage T1c/T2, PSA ≤ 10 ng/ml, PSA density (PSAD) < 0.2 ng/ml per milliliter, one or two positive biopsy cores, and Gleason score (GS) ≤ 6 at initial diagnostic biopsy.In this analysis, we defined the patients presenting no reclassification with cancer after first protocol biopsy as NR-CA group and the patients presenting no reclassification showing pT0 as NR-noCA group. We compared AS remaining rate, pathological outcomes in extra biopsy and second protocol biopsy at 4 years between two groups. Results: First protocol biopsy was performed on 514 patients. 191 patients were in NR-noCA group and 199 patients were in NR-CA group. Patients background of NR-noCA group was as follows: Median age was 68, median PSA was 5.6ng/ml, and median prostate volume was 38.4cc. T1c were in 183 and T2a were in 8. At the time of first protocol biopsy, there was no significant differences about PSA parameters and pathological factors between NR-noCA group and NR-CA group. Also, extra biopsy performing rate (NR-noCA group vs NR-CA group; 5.75% vs 7.53%) and implementation rate of second protocol biopsy at 4 years (75.6% vs 63.6%) showed no significant differences. On second protocol biopsy, number of cancer positive cores were significantly smaller and rate of pT0 was higher in NR-noCA group. After five years, both group showed comparable AS remaining rate (76.9 vs 75.3%). Thirty eight patients of NR-noCA group selected definitive therapy and surgery was the most frequently chosen treatment option. Conclusions: Although rate of pT0 on second biopsy was higher in NR-noCA group, there was no significant difference between both groups in AS remaining rate. The patients in NR-noCA group tended to choose surgery as a definitive therapy. Clinical trial information: UMIN000002874.

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