TY - JOUR
T1 - Comparison of outcomes of different biopsy schedules among men on active surveillance for prostate cancer
T2 - An analysis of the G.A.P.3 global consortium database
AU - Beckmann, Kerri R.
AU - Bangma, Chris H.
AU - the Global Action Plan Active Surveillance Prostate Cancer [G.A.P.3] Consortium
AU - Helleman, Jozien
AU - Bjartell, Anders
AU - Carroll, Peter R.
AU - Morgan, Todd
AU - Nieboer, Daan
AU - Santaolalla, Aida
AU - Trock, Bruce J.
AU - Valdagni, Riccardo
AU - Roobol, Monique J.
N1 - Funding Information: This study was supported by the Movember Foundation. Dr. Beckmann is supported by a National Health and Medical Research Council Sydney Sax Fellowship (1124210).
Publisher Copyright: © 2022 The Authors. The Prostate published by Wiley Periodicals LLC.
PY - 2022/5/15
Y1 - 2022/5/15
N2 - Background: The optimal interval for repeat biopsy during active surveillance (AS) for prostate cancer is yet to be defined. This study examined whether risk of upgrading (to grade group ≥ 2) or risk of converting to treatment varied according to intensity of repeat biopsy using data from the GAP3 consortium's global AS database. Materials and Methods: Intensity of surveillance biopsy schedules was categorized according to centers’ protocols: (a) Prostate Cancer Research International Active Surveillance project (PRIAS) protocols with biopsies at years 1, 4, and 7 (10 centers; 7532 men); (b) biennial biopsies, that is, every other year (8 centers; 4365 men); and (c) annual biopsy schedules (4 centers; 1602 men). Multivariable Cox regression was used to compare outcomes according to biopsy intensity. Results: Out of the 13,508 eligible participants, 56% were managed according to PRIAS protocols (biopsies at years 1, 4, and 7), 32% via biennial biopsy, and 12% via annual biopsy. After adjusting for baseline characteristics, risk of converting to treatment was greater for those on annual compared with PRIAS biopsy schedules (hazard ratio [HR] = 1.66; 95% confidence interval [CI] = 1.51–1.83; p < 0.001), while risk of upgrading did not differ (HR = 0.96; 95% CI = 0.84–1.10). Conclusion: Results suggest more frequent biopsy schedules may deter some men from continuing AS despite no evidence of grade progression.
AB - Background: The optimal interval for repeat biopsy during active surveillance (AS) for prostate cancer is yet to be defined. This study examined whether risk of upgrading (to grade group ≥ 2) or risk of converting to treatment varied according to intensity of repeat biopsy using data from the GAP3 consortium's global AS database. Materials and Methods: Intensity of surveillance biopsy schedules was categorized according to centers’ protocols: (a) Prostate Cancer Research International Active Surveillance project (PRIAS) protocols with biopsies at years 1, 4, and 7 (10 centers; 7532 men); (b) biennial biopsies, that is, every other year (8 centers; 4365 men); and (c) annual biopsy schedules (4 centers; 1602 men). Multivariable Cox regression was used to compare outcomes according to biopsy intensity. Results: Out of the 13,508 eligible participants, 56% were managed according to PRIAS protocols (biopsies at years 1, 4, and 7), 32% via biennial biopsy, and 12% via annual biopsy. After adjusting for baseline characteristics, risk of converting to treatment was greater for those on annual compared with PRIAS biopsy schedules (hazard ratio [HR] = 1.66; 95% confidence interval [CI] = 1.51–1.83; p < 0.001), while risk of upgrading did not differ (HR = 0.96; 95% CI = 0.84–1.10). Conclusion: Results suggest more frequent biopsy schedules may deter some men from continuing AS despite no evidence of grade progression.
UR - http://www.scopus.com/inward/record.url?scp=85126054260&partnerID=8YFLogxK
U2 - 10.1002/pros.24330
DO - 10.1002/pros.24330
M3 - Article
C2 - 35254666
AN - SCOPUS:85126054260
SN - 0270-4137
VL - 82
SP - 876
EP - 879
JO - Prostate
JF - Prostate
IS - 7
ER -
