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• W2074244022 abstract "You have accessJournal of UrologyImaging/Radiology: Uroradiology (II)1 Apr 20132186 MONITORING OF THREE-DIMENSIONALLY MAPPED BIOPSY-PROVEN IMAGE-VISIBLE LESIONS OF PROSTATE CANCER ON ACTIVE SURVEILLANCE: 11 YEAR EXPERIENCE Sunao Shoji, Osamu Ukimura, Andre Luis De Castro Abreu, Scott Leslie, Toyoaki Uchida, Inderbir Gill, and Duke Bahn Sunao ShojiSunao Shoji Los Angeles, Japan More articles by this author , Osamu UkimuraOsamu Ukimura Los Angeles, Japan More articles by this author , Andre Luis De Castro AbreuAndre Luis De Castro Abreu Los Angeles, CA More articles by this author , Scott LeslieScott Leslie Los Angeles, CA More articles by this author , Toyoaki UchidaToyoaki Uchida Hachioji, Japan More articles by this author , Inderbir GillInderbir Gill Los Angeles, Japan More articles by this author , and Duke BahnDuke Bahn Los Angeles, CA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2095AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To report our 11 year experience of TRUS-based monitoring of biopsy-proven, visible lesions mapped within the 3D space of the prostate for men with prostate cancer on active surveillance (AS). METHODS Of 240 patients undergoing AS for low-to-intermediate risk prostate cancer, 143 had a biopsy-proven TRUS-visible lesion. Surveillance protocol included 3-6 monthly PSA, 6-12 monthly TRUS, and surveillance biopsy at 2-3 years or if indicated. Of the 143 patients, 37 had at least 3 times TRUS monitoring of the identical visible lesion, which could them be compared to the initial TRUS with 3-dementional schematic mapping of the lesion within the prostate. Median follow-up for these 37 patients was 50 months. Clinical variables (median) included age (61 years), clinical stage (T1c, 31; T2, 6), PSA (4.3 ng/ml), Gleason score (3+3, n=32; 3+4, n=5). Pathological progression of the surveillance biopsy was defined as upgrading in Gleason score or a 25% increase in biopsy core percentage. Doppler grade of blood flow within the lesion was classified from grade 0 to 3 (0, no flow; 1, low; 2, moderate; 3, high). RESULTS Of the 37 patients, 24 demonstrated pathological progression at a median follow-up of 53 months. In these 24 patients, there was a significant increase in the size of the visible lesion, with a 19% increase in lesion diameter when compared to the 13 patients who did not have pathological progression (p=0.001). Furthermore, upgrade of the Doppler signal within the lesion occurred in 19 (79%) of the 24 patients with progression compared with only 1 (8%) of the 13 patients with stable disease (p<0.001). CONCLUSIONS Longitudinal documentation of the TRUS -visible biopsy proven cancer (Figure) provides a new opportunity to perform per-lesion based active surveillance for prostate cancer. The precision and reliability afforded by 3D mapping of the biopsy-proven cancer potentially contributes to more precise AS when compared to the current image-blinded systematic biopsy approach. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e896-e897 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sunao Shoji Los Angeles, Japan More articles by this author Osamu Ukimura Los Angeles, Japan More articles by this author Andre Luis De Castro Abreu Los Angeles, CA More articles by this author Scott Leslie Los Angeles, CA More articles by this author Toyoaki Uchida Hachioji, Japan More articles by this author Inderbir Gill Los Angeles, Japan More articles by this author Duke Bahn Los Angeles, CA More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ..." @default.
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• W2074244022 title "2186 MONITORING OF THREE-DIMENSIONALLY MAPPED BIOPSY-PROVEN IMAGE-VISIBLE LESIONS OF PROSTATE CANCER ON ACTIVE SURVEILLANCE: 11 YEAR EXPERIENCE" @default.
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