{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T18:35:55Z","timestamp":1790706955688,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"6b","license":[{"start":{"date-parts":[[2014,8,11]],"date-time":"2014-08-11T00:00:00Z","timestamp":1407715200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2014,12]]},"abstract":"\n Objective<\/jats:title>\n \n To evaluate the clinical and pathological factors influencing the risk of disease progression in a cohort of patients with low\u2013intermediate risk prostate cancer under active surveillance (\n AS<\/jats:styled-content>\n ).\n <\/jats:p>\n <\/jats:sec>\n \n Patients and Methods<\/jats:title>\n \n We studied 300 patients diagnosed between 1992 and 2012 with prostate adenocarcinoma with favourable parameters or who refused treatment and were managed with\n AS<\/jats:styled-content>\n . Of those, 155 patients with at least one repeat biopsy and no progression criteria at the time of the diagnosis were included for statistical analyses. Patients were followed every 3\u20136 months for prostate\u2010specific antigen (\n PSA<\/jats:styled-content>\n ) measurement and physical examination. Patients were offered repeat prostatic biopsy every year. Disease progression was defined as the presence of one or more of the following criteria: \u22653 positive cores, >50% of cancer in at least one core, and a predominant\n G<\/jats:styled-content>\n leason pattern of 4.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n For the 155 patients, the mean (\n sd<\/jats:sc>\n ) age at diagnosis was 67\u2009(7) years; the median (interquartile range) follow\u2010up was 5.4\u2009(3.6\u20139.5) years. Of these, 67, 25, six, and two patients had two, three, four, and five repeat biopsies, respectively. At baseline, 11 (7%) patients had a Gleason score of 3+4, while the remaining 144 (93%) patients had a\n G<\/jats:styled-content>\n leason score of \u22646. In all, 50 (32.3%) patients had disease progression on repeat biopsies, with a median progression\u2010free survival time of 7 years. The rate of disease progression decreased after the second repeat biopsy. The 5\u2010year overall survival rate was 100%. Having a\n PSA<\/jats:styled-content>\n density (\n PSAD<\/jats:styled-content>\n ) of >0.15\u2009ng\/mL\/mL, >1\u2009positive core, and Gleason score >6 at the time of the diagnosis was associated with a significantly higher rate of disease progression on univariate analysis (\n P<\/jats:italic>\n < 0.05), while a maximum percentage of cancer in any core of >10% showed a trend toward significance for a higher progression rate (\n P<\/jats:italic>\n = 0.054). On multivariate analysis, only the presence of a\n PSAD<\/jats:styled-content>\n of >0.15\u2009ng\/mL\/mL remained significant for a higher progression rate (\n P<\/jats:italic>\n < 0.05). Of the 155 patients, five (3.2%) subsequently received radiotherapy, 13 (8.4%) received hormonal therapy, and 13 (8.4%) underwent radical prostatectomy.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n AS<\/jats:styled-content>\n is a suitable management option for patients with clinically low\u2010risk prostate cancer. A\n PSAD<\/jats:styled-content>\n of >0.15\u2009ng\/mL\/mL is an important predictor for disease progression.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/bju.12754","type":"journal-article","created":{"date-parts":[[2014,3,31]],"date-time":"2014-03-31T09:30:16Z","timestamp":1396258216000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Factors influencing disease progression of prostate cancer under active surveillance: a\n M<\/scp>\n c\n G<\/scp>\n ill\n U<\/scp>\n niversity\n H<\/scp>\n ealth\n C<\/scp>\n enter cohort"],"prefix":"10.1111","volume":"114","author":[{"given":"Ghassan A.","family":"Barayan","sequence":"first","affiliation":[{"name":"Division of Urology Department of Surgery McGill University Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fadi","family":"Brimo","sequence":"additional","affiliation":[{"name":"Department of Pathology McGill University Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis R.","family":"B\u00e9gin","sequence":"additional","affiliation":[{"name":"Department of Pathology McGill University Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James A.","family":"Hanley","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics McGill University Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhihui","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics McGill University Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wassim","family":"Kassouf","sequence":"additional","affiliation":[{"name":"Division of Urology Department of Surgery McGill University Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armen G.","family":"Aprikian","sequence":"additional","affiliation":[{"name":"Division of Urology Department of Surgery McGill University Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Tanguay","sequence":"additional","affiliation":[{"name":"Division of Urology Department of Surgery McGill University Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,8,11]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"Canadian Cancer Society.Canadian cancer statistics 2013.2013. 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