Factors associated with time to conversion from active surveillance to treatment for prostate cancer in a multi-institutional cohort Journal Article
| Authors: | Folgosa Cooley, L.; Emeka, A. A.; Meyers, T. J.; Cooper, P. R.; Lin, D. W.; Finelli, A.; Eastham, J. A.; Logothetis, C. J.; Marks, L. S.; Vesprini, D.; Goldenberg, S. L.; Higano, C. S.; Pavlovich, C. P.; Chan, J. M.; Morgan, T. M.; Klein, E. A.; Barocas, D. A.; Loeb, S.; Helfand, B. T.; Scholtens, D. M.; Witte, J. S.; Catalona, W. J. |
| Contributors: | Ehdaie, B.; Benfante, N. |
| Article Title: | Factors associated with time to conversion from active surveillance to treatment for prostate cancer in a multi-institutional cohort |
| Abstract: | PURPOSE: We examined the demographic and clinicopathological parameters associated with the time to convert from active surveillance to treatment among men with prostate cancer. MATERIALS AND METHODS: A multi-institutional cohort of 7,279 patients managed with active surveillance had data and biospecimens collected for germline genetic analyses. RESULTS: Of 6,775 men included in the analysis, 2,260 (33.4%) converted to treatment at a median followup of 6.7 years. Earlier conversion was associated with higher Gleason grade groups (GG2 vs GG1 adjusted hazard ratio [aHR] 1.57, 95% CI 1.36-1.82; ≥GG3 vs GG1 aHR 1.77, 95% CI 1.29-2.43), serum prostate specific antigen concentrations (aHR per 5 ng/ml increment 1.18, 95% CI 1.11-1.25), tumor stages (cT2 vs cT1 aHR 1.58, 95% CI 1.41-1.77; ≥cT3 vs cT1 aHR 4.36, 95% CI 3.19-5.96) and number of cancerous biopsy cores (3 vs 1-2 cores aHR 1.59, 95% CI 1.37-1.84; ≥4 vs 1-2 cores aHR 3.29, 95% CI 2.94-3.69), and younger age (age continuous per 5-year increase aHR 0.96, 95% CI 0.93-0.99). Patients with high-volume GG1 tumors had a shorter interval to conversion than those with low-volume GG1 tumors and behaved like the higher-risk patients. We found no significant association between the time to conversion and self-reported race or genetic ancestry. CONCLUSIONS: A shorter time to conversion from active surveillance to treatment was associated with higher-risk clinicopathological tumor features. Furthermore, patients with high-volume GG1 tumors behaved similarly to those with intermediate and high-risk tumors. An exploratory analysis of self-reported race and genetic ancestry revealed no association with the time to conversion. |
| Keywords: | prostatic neoplasms; watchful waiting; race factors; human genetics |
| Journal Title: | Journal of Urology |
| Volume: | 206 |
| Issue: | 5 |
| ISSN: | 0022-5347 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2021-11-01 |
| Start Page: | 1147 |
| End Page: | 1155; discussion 1155-1156 |
| Language: | English |
| DOI: | 10.1097/ju.0000000000001937 |
| PROVIDER: | scopus |
| PUBMED: | 34503355 |
| PMCID: | PMC8734323 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 December 2021 -- Source: Scopus |
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