{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T02:23:02Z","timestamp":1740104582879,"version":"3.37.3"},"reference-count":13,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,12,2]],"date-time":"2019-12-02T00:00:00Z","timestamp":1575244800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Prostate"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Active surveillance (AS) has become a valid option for patients with a very low risk of prostate cancer (PC) with a widespread application. There are still a few series, with a medium follow\u2010up longer than 5 years, reporting data on pathological upgrading. The objective is to evaluate the changes in surveillance biopsies of patients with low\u2010risk PC in a long\u2010term follow\u2010up and determine if a longer stay in AS could involve worse pathological findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>A retrospective analysis of our institutional database of patients with PC undergoing AS during 2004 to 2018 was performed. The inclusion criteria were prostate\u2010specific antigen (PSA)\u2009\u2264\u200910\u2009ng\/mL, Gleason grade 1 and T1c\/T2a. Patients were assessed by serum PSA level and digital rectal examination at 6\u2010month intervals. Transrectal ultrasound\u2010guided prostate biopsies were performed during the first year of follow\u2010up, and every 2 or 3 years thereafter. The pathology details of biopsies were analyzed and compared with the current series on AS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Three\u2010hundred nineteen patients undergoing AS were evaluated with a median follow\u2010up of 5.3 years and a mean age of 67.4 years. Sixty\u2010three patients did not meet all the criteria to be considered low\u2010risk PC but were included in the analysis. Overall, 128 patients (40.1%) underwent active treatment (84.7% of them due to pathological progression in surveillance biopsies). The proportion of patients with a reported upgrading ranged between 19.4% and 35.3%, although only the fourth biopsy showed an upgrading proportion of over 30%. Limitations include the retrospective design of the study and the existence of different protocols between other cohorts that make it difficult to compare their results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>For patients who remained in surveillance the percentage of upgrading increased slightly with the time, being more frequent after the third\u2010surveillance biopsy. These findings support the importance of extending surveillance biopsies for patients who remain candidates for curative treatment.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pros.23933","type":"journal-article","created":{"date-parts":[[2019,12,2]],"date-time":"2019-12-02T23:38:47Z","timestamp":1575329927000},"page":"209-213","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prostate cancer adverse pathology reclassification in patients undergoing active surveillance in a long\u2010term follow\u2010up series"],"prefix":"10.1002","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7317-9107","authenticated-orcid":false,"given":"Guillermo","family":"Fern\u00e1ndez\u2010Conejo","sequence":"first","affiliation":[{"name":"Department of Urology Hospital Universitario Fundaci\u00f3n Alcorc\u00f3n Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Virginia","family":"Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Department of Urology Hospital Universitario Fundaci\u00f3n Alcorc\u00f3n Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Guijarro","sequence":"additional","affiliation":[{"name":"Department of Urology Hospital Universitario Fundaci\u00f3n Alcorc\u00f3n Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enrique","family":"de la Pe\u00f1a","sequence":"additional","affiliation":[{"name":"Department of Urology Hospital Universitario Fundaci\u00f3n Alcorc\u00f3n Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"In\u00e9s","sequence":"additional","affiliation":[{"name":"Department of Urology Hospital Universitario Fundaci\u00f3n Alcorc\u00f3n Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elia","family":"P\u00e9rez\u2010Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Unit of Research Hospital Universitario Fundaci\u00f3n Alcorc\u00f3n Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Llorente","sequence":"additional","affiliation":[{"name":"Department of Urology Hospital Universitario Fundaci\u00f3n Alcorc\u00f3n Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,12,2]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"MottetN BellmuntJ BriersE et al.EAU Guidelines.Edn. presented at theEAU Annual Congress Copenhagen2018; 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