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MAAUA 68th Annual Meeting Abstracts
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Active Surveillance Program at a Tertiary Veterans Affairs Medical Center
Blake Moore1, *MaryEllen Cleary1, Adam Klausner2, Georgi Guruli2, Lance Hampton2, B. Mayer Grob2
1Virginia Commonwealth University, Medical College of Virginia, Richmond, VA;2McGuire VA Medical Center, VCU Medical Center, Richmond, VA
Introduction: Active surveillance has become an accepted practice in an effort to reduce over-treatment of prostate cancer. The purpose of this study is to evaluate initial data after the establishment of an active surveillance program at a VA medical center and to compare these patients to those with delayed biopsy.
Materials & Methods: A retrospective review identified 42 men who were diagnosed with prostate cancer and met criteria for active surveillance. We followed patients with a PSA every 6 months and annual biopsy, unless prompted by an increasing PSA value.
Results: 42 patients met criteria for active surveillance with 33 followed per our guidelines and the remainder having delayed biopsy. Among the 33 patients, 21 had repeat biopsies at an average of 11.1 months compared to 9 patients with delayed biopsies at 33.4 months. Five men have chosen definitive treatment at an average of 11 months. The number of positive cores from initial to repeat biopsy increased by 37% for in-program patients (IP) and 54.8% for delayed biopsy patients (DB). Total Gleason score increased by 0.7 for IP and 1.2 for DB between biopsies. On repeat biopsy, 14% of IP converted to a Gleason score ≥8 compared to 33% for patients with delayed biopsy.
Conclusions: We have demonstrated that an active surveillance program can be safely and effectively established at a VAMC. Although the ideal time frame for repeat biopsy remains unclear, waiting 2.5 years may place patients at increased risk for local progression.
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