Yonsei criteria: A new protocol for active surveillance in the era of robotic and local ablative surgeries

Sey Kiat Lim, Kwang Hyun Kim, Tae Young Shin, Byungha Chung, Sung Joon Hong, Youngdeuk Choi, KoonHo Rha

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: The objective of this study was to develop a new AS protocol and compare it with the existing selected published AS protocols by examining the pathological characteristics of post-RARP specimens in patients eligible for AS. Materials and Methods: From a database of 1046 patients, 344 post-RARP patients with biopsy Gleason scores ≤ 6 prostate cancer (PCa) without neoadjuvant therapy were included. Six AS protocols were identified and evaluated for pathological and oncological end points. Four new AS criteria were proposed and evaluated. The probabilities of each end point were estimated using logistic regression modeling. Areas under the receiver operating curve were calculated for each protocol and end point. Results: Across all the selected protocols, biochemical recurrence occurred in 0 to 1.9% of patients; extracapsular extension (ECE) in 0 to 5.9%; lymph node involvement (LNI) in 0 to 1.3%; and upgrading to Gleason score ≥ 7 in 12.9% to 36.4%. We found that our new AS criteria: cT1-cT2 PCa; biopsy Gleason score ≤ 6; prostate-specific antigen ≤ 10 ng/mL; ≤ 1 positive biopsy core; and ≤ 50% core involvement compared favorably with other protocols. Area under the receiver operating curve analyses showed good predictive power of our AS criteria for the pathological and oncological end points of our study. Conclusion: Existing AS protocols do not satisfactorily predict insignificant PCas in our cohort, hence necessitating the need for new AS criteria in the era of robotic and local ablative surgeries. No patients in our cohort had biochemical recurrence, LNI, or ECE of their PCas when our protocol was applied.

Original languageEnglish
Pages (from-to)501-507
Number of pages7
JournalClinical Genitourinary Cancer
Volume11
Issue number4
DOIs
Publication statusPublished - 2013 Dec 1

Fingerprint

Robotics
Neoplasm Grading
Biopsy
Prostatic Neoplasms
Lymph Nodes
Recurrence
Neoadjuvant Therapy
Prostate-Specific Antigen
Logistic Models
Databases

All Science Journal Classification (ASJC) codes

  • Oncology
  • Urology

Cite this

@article{c4b826b8ec55499b9eadbd638ec86920,
title = "Yonsei criteria: A new protocol for active surveillance in the era of robotic and local ablative surgeries",
abstract = "Background: The objective of this study was to develop a new AS protocol and compare it with the existing selected published AS protocols by examining the pathological characteristics of post-RARP specimens in patients eligible for AS. Materials and Methods: From a database of 1046 patients, 344 post-RARP patients with biopsy Gleason scores ≤ 6 prostate cancer (PCa) without neoadjuvant therapy were included. Six AS protocols were identified and evaluated for pathological and oncological end points. Four new AS criteria were proposed and evaluated. The probabilities of each end point were estimated using logistic regression modeling. Areas under the receiver operating curve were calculated for each protocol and end point. Results: Across all the selected protocols, biochemical recurrence occurred in 0 to 1.9{\%} of patients; extracapsular extension (ECE) in 0 to 5.9{\%}; lymph node involvement (LNI) in 0 to 1.3{\%}; and upgrading to Gleason score ≥ 7 in 12.9{\%} to 36.4{\%}. We found that our new AS criteria: cT1-cT2 PCa; biopsy Gleason score ≤ 6; prostate-specific antigen ≤ 10 ng/mL; ≤ 1 positive biopsy core; and ≤ 50{\%} core involvement compared favorably with other protocols. Area under the receiver operating curve analyses showed good predictive power of our AS criteria for the pathological and oncological end points of our study. Conclusion: Existing AS protocols do not satisfactorily predict insignificant PCas in our cohort, hence necessitating the need for new AS criteria in the era of robotic and local ablative surgeries. No patients in our cohort had biochemical recurrence, LNI, or ECE of their PCas when our protocol was applied.",
author = "Lim, {Sey Kiat} and Kim, {Kwang Hyun} and Shin, {Tae Young} and Byungha Chung and Hong, {Sung Joon} and Youngdeuk Choi and KoonHo Rha",
year = "2013",
month = "12",
day = "1",
doi = "10.1016/j.clgc.2013.04.024",
language = "English",
volume = "11",
pages = "501--507",
journal = "Clinical Genitourinary Cancer",
issn = "1558-7673",
publisher = "Elsevier",
number = "4",

}

Yonsei criteria : A new protocol for active surveillance in the era of robotic and local ablative surgeries. / Lim, Sey Kiat; Kim, Kwang Hyun; Shin, Tae Young; Chung, Byungha; Hong, Sung Joon; Choi, Youngdeuk; Rha, KoonHo.

In: Clinical Genitourinary Cancer, Vol. 11, No. 4, 01.12.2013, p. 501-507.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Yonsei criteria

T2 - A new protocol for active surveillance in the era of robotic and local ablative surgeries

AU - Lim, Sey Kiat

AU - Kim, Kwang Hyun

AU - Shin, Tae Young

AU - Chung, Byungha

AU - Hong, Sung Joon

AU - Choi, Youngdeuk

AU - Rha, KoonHo

PY - 2013/12/1

Y1 - 2013/12/1

N2 - Background: The objective of this study was to develop a new AS protocol and compare it with the existing selected published AS protocols by examining the pathological characteristics of post-RARP specimens in patients eligible for AS. Materials and Methods: From a database of 1046 patients, 344 post-RARP patients with biopsy Gleason scores ≤ 6 prostate cancer (PCa) without neoadjuvant therapy were included. Six AS protocols were identified and evaluated for pathological and oncological end points. Four new AS criteria were proposed and evaluated. The probabilities of each end point were estimated using logistic regression modeling. Areas under the receiver operating curve were calculated for each protocol and end point. Results: Across all the selected protocols, biochemical recurrence occurred in 0 to 1.9% of patients; extracapsular extension (ECE) in 0 to 5.9%; lymph node involvement (LNI) in 0 to 1.3%; and upgrading to Gleason score ≥ 7 in 12.9% to 36.4%. We found that our new AS criteria: cT1-cT2 PCa; biopsy Gleason score ≤ 6; prostate-specific antigen ≤ 10 ng/mL; ≤ 1 positive biopsy core; and ≤ 50% core involvement compared favorably with other protocols. Area under the receiver operating curve analyses showed good predictive power of our AS criteria for the pathological and oncological end points of our study. Conclusion: Existing AS protocols do not satisfactorily predict insignificant PCas in our cohort, hence necessitating the need for new AS criteria in the era of robotic and local ablative surgeries. No patients in our cohort had biochemical recurrence, LNI, or ECE of their PCas when our protocol was applied.

AB - Background: The objective of this study was to develop a new AS protocol and compare it with the existing selected published AS protocols by examining the pathological characteristics of post-RARP specimens in patients eligible for AS. Materials and Methods: From a database of 1046 patients, 344 post-RARP patients with biopsy Gleason scores ≤ 6 prostate cancer (PCa) without neoadjuvant therapy were included. Six AS protocols were identified and evaluated for pathological and oncological end points. Four new AS criteria were proposed and evaluated. The probabilities of each end point were estimated using logistic regression modeling. Areas under the receiver operating curve were calculated for each protocol and end point. Results: Across all the selected protocols, biochemical recurrence occurred in 0 to 1.9% of patients; extracapsular extension (ECE) in 0 to 5.9%; lymph node involvement (LNI) in 0 to 1.3%; and upgrading to Gleason score ≥ 7 in 12.9% to 36.4%. We found that our new AS criteria: cT1-cT2 PCa; biopsy Gleason score ≤ 6; prostate-specific antigen ≤ 10 ng/mL; ≤ 1 positive biopsy core; and ≤ 50% core involvement compared favorably with other protocols. Area under the receiver operating curve analyses showed good predictive power of our AS criteria for the pathological and oncological end points of our study. Conclusion: Existing AS protocols do not satisfactorily predict insignificant PCas in our cohort, hence necessitating the need for new AS criteria in the era of robotic and local ablative surgeries. No patients in our cohort had biochemical recurrence, LNI, or ECE of their PCas when our protocol was applied.

UR - http://www.scopus.com/inward/record.url?scp=84887998880&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84887998880&partnerID=8YFLogxK

U2 - 10.1016/j.clgc.2013.04.024

DO - 10.1016/j.clgc.2013.04.024

M3 - Article

C2 - 23810442

AN - SCOPUS:84887998880

VL - 11

SP - 501

EP - 507

JO - Clinical Genitourinary Cancer

JF - Clinical Genitourinary Cancer

SN - 1558-7673

IS - 4

ER -