Prostate volume is an independent predictive factor in selecting low-risk prostate patients for active surveillance

Purpose The outcome of the present study is to determine variables available at time diagnosis able predict disease reclassification in prostate cancer (PCa) patients on active surveillance (AS). Materials and methods From January 2014 December 2018, 114 consecutive low-risk PCa were enrolled AS protocol according inclusion criteria: PSA ≤ 10 ng/ml, Gleason score (GS) 6 or International Society Urological Pathology (ISUP) grade group (GG) 1, maximum core length (MCCI) < 50%, 2 positive cores biopsy. Patients followed with confirmatory yearly biopsy, semi-annually prostate-specific antigen (PSA), digital rectal examination (DRE). Disease was defined as upgrading biopsy: GS ≥ 3 + 4 = 7 ISUP GG 2, more than two cores, MCCI > changes serum ng/ml. Uni- multivariate Cox proportional hazards regression models, receiver performance curves (ROC), Kaplan-Meier analysis performed characterize criteria identify that reclassification. Finally, decision curve (DCA) evaluate net benefit using PV addition standard Results diagnosed by systematic transrectal ultrasound-guided biopsy (TRUS-Bx). mean (range) follow-up 32.7 (12-126) months. occurred 46 (40%). On univariate statistical specific (PSA) (p 0.05), volume (PV) 0.022), density (PSAD) 0.001) number 0.021) significant factors for analysis, PSAD 0.003) only statistically independent A cut-off 0.16 ng/ml² a 44 ml gave maximal area under curve, 0.69 0.63, respectively. showed median survival free from during almost doubled ng/ml ml. DCA clinical usefulness model, including PV, between threshold probabilities 20-50%. Conclusions significantly predicted failure our patients. baseline fewer would be likely have unsuitable acceptable protocols. Therefore, we believe may help select AS, especially populations where use mpMRI limited.