{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T09:44:47Z","timestamp":1776246287289,"version":"3.50.1"},"reference-count":7,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"abstract":"\n Objective<\/jats:title>\n To describe outcomes and identify predictors of histological progression in men on active surveillance (AS) for International Society of Urological Pathology Grade Group (ISUP GG) 1 prostate cancer in New Zealand (NZ), as AS is the standard management for favourable\u2010risk prostate cancer, yet NZ\u2010specific outcome data remain limited.<\/jats:p>\n <\/jats:sec>\n \n Patients and Methods<\/jats:title>\n A retrospective study of the North Shore Hospital AS programme (2014\u20132020) was conducted. Records were reviewed in 2024. In total, 296 men with ISUP GG 1 disease on AS were included. Primary endpoints were histological progression to ISUP GG \u22652, treatment conversion, and disease\u2010related mortality.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Over a mean 7.4\u2010year follow\u2010up, 36.5% progressed, 33.4% required treatment, 12.1% recurred after treatment, and one patient died from metastatic disease. Within the cohort, a low\u2010risk subgroup of 93 patients with ISUP GG 1 prostate cancer had low prostate\u2010specific antigen (PSA) density and no suspicious magnetic resonance imaging (MRI) lesions. Of these patients, 16 (17.2%) progressed. On multivariate analysis, independent predictors of progression were PSA density \u22650.15\u2009ng\/mL\/mL (odds ratio [OR] 3.45) and Prostate Imaging\u2010Reporting and Data System 3\u20135 lesions (OR 3.52).<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Active surveillance is a safe option for low\u2010risk prostate cancer, our data are consistent with outcomes consistent with the Prostate Cancer Outcomes Registry and international data. PSA density and multiparametric MRI were the strongest predictors of progression; tumour volume by percentage of positive cores was not independently predictive.<\/jats:p>\n New draft Prostate Cancer Foundation of Australia guidelines recommend against biopsy in men with PSA density <0.15 ng\/mL\/cc and no PIRADS 3\u20135 lesion on MRI[7], in our cohort this included many men with ISUP 1 cancer. They had a 17.2% progression rate to ISUP \u22652, and their clinically significant disease might have been missed without close surveillance.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/bju.70276","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T08:44:36Z","timestamp":1776242676000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes and progression predictors in a New Zealand active surveillance programme for prostate cancer"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-2134-6804","authenticated-orcid":false,"given":"Kain","family":"Xu","sequence":"first","affiliation":[{"name":"North Shore Hospital, Auckland, Te Whatu Ora Health New Zealand New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikhar","family":"Shah","sequence":"additional","affiliation":[{"name":"North Shore Hospital, Auckland, Te Whatu Ora Health New Zealand New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dug Yeo","family":"Han","sequence":"additional","affiliation":[{"name":"Health New Zealand Research Evidence and Pathways Health New Zealand Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madhu","family":"Koya","sequence":"additional","affiliation":[{"name":"North Shore Hospital, Auckland, Te Whatu Ora Health New Zealand New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tony","family":"Beaven","sequence":"additional","affiliation":[{"name":"North Shore Hospital, Auckland, Te Whatu Ora Health New Zealand New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,4,15]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"DRAFT 2025 Guidelines for the Early Detection of Prostate Cancer: Clinical Practice Guidelines","author":"Prostate Cancer Foundation of Australia, PSA Guideline Review Expert Advisory Panel","year":"2025"},{"key":"e_1_2_8_3_1","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1001\/jama.2019.20675","article-title":"Patient\u2010reported outcomes through 5\u2009years for active surveillance, surgery, brachytherapy, or external beam radiation with or without androgen deprivation therapy for localized prostate cancer","volume":"323","author":"Hoffman KE","year":"2020","journal-title":"JAMA"},{"key":"e_1_2_8_4_1","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1016\/j.eururo.2019.02.033","article-title":"Prostate imaging reporting and data system version 2.1: 2019 update of prostate imaging reporting and data system version 2","volume":"76","author":"Turkbey B","year":"2019","journal-title":"Eur Urol"},{"key":"e_1_2_8_5_1","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1200\/JCO.2014.55.1192","article-title":"Long\u2010term follow\u2010up of a large active surveillance cohort of patients with prostate cancer","volume":"33","author":"Klotz L","year":"2015","journal-title":"J Clin Oncol"},{"key":"e_1_2_8_6_1","first-page":"3363","article-title":"Active surveillance program for prostate cancer: an update of the Johns Hopkins experience","volume":"33","author":"Tosoian JJ","year":"2015","journal-title":"J Clin Oncol"},{"key":"e_1_2_8_7_1","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-020-76786-9","article-title":"The use of prostate specific antigen density to predict clinically significant prostate cancer","volume":"10","author":"Yusim I","year":"2020","journal-title":"Sci Rep"},{"key":"e_1_2_8_8_1","article-title":"Prostate MRI, with or without MRI\u2010targeted biopsy, and systematic biopsy for detecting prostate cancer","volume":"4","author":"Drost FH","year":"2019","journal-title":"Cochrane Database Syst Rev"}],"container-title":["BJU International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/bjui-journals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bju.70276","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/bjui-journals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/bju.70276","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/bjui-journals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bju.70276","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T08:44:38Z","timestamp":1776242678000},"score":1,"resource":{"primary":{"URL":"https:\/\/bjui-journals.onlinelibrary.wiley.com\/doi\/10.1111\/bju.70276"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,15]]},"references-count":7,"alternative-id":["10.1111\/bju.70276"],"URL":"https:\/\/doi.org\/10.1111\/bju.70276","archive":["Portico"],"relation":{},"ISSN":["1464-4096","1464-410X"],"issn-type":[{"value":"1464-4096","type":"print"},{"value":"1464-410X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,15]]},"assertion":[{"value":"2026-04-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"bju.70276"}}