Does active surveillance avoid overtreatment in prostate cancer? Lessons learned from salvage radical prostatectomies | Actas Urológicas Españolas (English Edition)

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"apellidos" => "Polo Alonso" "email" => array:1 [ 0 => "epoloalonso@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "M." "apellidos" => "Ramírez-Backhaus" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "G." "apellidos" => "Wei" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "J.M." "apellidos" => "Mascarós" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "F." "apellidos" => "Aragón Rodriguez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "Á." 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"apellidos" => "Rubio-Briones" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Departamento de Urología, Fundación Instituto Valenciano de Oncología, Valencia, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Department of Surgery, Austin Health, The University of Melbourne, Melbourne, Victoria, Australia" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Young Urology Researchers Organisation (YURO), Melbourne, Victoria, Australia" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Departamento de Patología, Fundacion Instituto Valenciano de Oncologia, Valencia, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "¿La vigilancia activa evita el sobretratamiento en el cáncer de próstata? Lecciones aprendidas de prostatectomías radicales de rescate" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2349 "Ancho" => 2508 "Tamanyo" => 252837 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Biochemical recurrence-free survival rates of patients undergoing RP after AS. After a median follow-up of 48.3 months (IQR: 32.4–70) from diagnosis until last RP, the 3 year-BRFS post RP was 85.4% (95% CI: 78.3–93.1). RP, radical prostatectomy; IQR, interquartile range; BRFS, biochemical recurrence free survival." ] ] ] "textoCompleto" => "IntroductionThe availability of prostate specific antigen (PSA) screening for prostate cancer (PCa) has been widespread in recent decades, resulting in a considerable decrease in cancer related mortality in Western countries.<a class="elsevierStyleCrossRef" href="#bib0005">1</a> However, its prevalence has led to an increase in the detection of low risk PCa<a class="elsevierStyleCrossRef" href="#bib0010">2</a> and, subsequently, the potential to overtreatment.Almost one-third of patients diagnosed will have a low or very low risk of PCa progression.<a class="elsevierStyleCrossRef" href="#bib0010">2</a> As a result, active surveillance (AS) has been suggested as an alternative management strategy and involves close monitoring of low risk disease without offering radical treatment as an initial option. Ultimately, AS aims to avoid harmful overtreatment when there is no significant survival benefit.Whilst the concept of AS appears attractive, its uptake has occurred slowly.<a class="elsevierStyleCrossRef" href="#bib0015">3</a> Various factors have contributed to this hesitation including lack of clear guidelines surrounding patient selection, follow-up regimen and indications for radical treatment. In addition, PCa may be under-classified on prostate biopsy which may result in delaying active treatment.<a class="elsevierStyleCrossRef" href="#bib0020">4</a> For this reason, it is important that any AS regimen takes into consideration its patient population and aims to standardise prostate biopsies.<a class="elsevierStyleCrossRef" href="#bib0025">5</a>In this study, we analyse the outcomes of patients who underwent radical prostatectomy (RP) after initially following our AS protocol. We studied the overtreatment ratio in this cohort based on different pathological criteria.<a class="elsevierStyleCrossRefs" href="#bib0030">6–8</a> We aimed to determine whether AS, using our institution protocol, is an appropriate strategy to minimize PCa overtreatment.MethodsWe retrospectively reviewed our center’s PCa Database between January 1994 and September 2018. A total of 3748 PCa patients are included in the database, 516 patients (14%) underwent AS after localized initial PCa diagnosis.Inclusion criteria definition for AS cohortOur inclusion criteria for AS were based on the PRIAS study,<a class="elsevierStyleCrossRef" href="#bib0045">9</a> with some minor modifications: PSA ≤ 10 ng/mL, prostate biopsy Gleason score (GS) ≤ 3 + 3 (we accepted GS 3 + 4 in patients older than 70 years), clinical stage T1a-b-c, maximum number of positive biopsy cores of 2 in 10–12 cores following transrectal ultrasound guided (TRUS) prostate biopsy and a maximum of 3 cores and less than 3 positive areas in a transperineal (TP) approach with prostate sector mapping ± targeted biopsies. When positive cores were taken on targeted biopsy and the corresponding area on the mapping template, we considered these to be the same affected area. Presence of less than 5 mm of PCa in any core is also needed. Biopsies were assessed for quality, at least 10 cores required to be taken and reviewed by a specialized uro-pathologist. Biopsies not meeting quality criteria were repeated. Other inclusion criteria comprised life expectancy more than 10 years, age less than 80 at time of diagnosis and ability to understand the AS protocol and provide consent. Patients who fulfilled the above criteria were considered “per-protocol AS” group.Additionally, in our AS cohort there were patients who did not fulfil rigid inclusion criteria. However, they were included for other reasons (e.g. patient wishes or the preferential management of other conditions). These patients were considered “induced AS” group in our study.AS protocol within our institutionIt included a confirmatory biopsy within 6–12 months after diagnosis, 1.5 T multiparametric Magnetic Resonance Imaging (mpMRI) performed as guidance. Confirmatory prostate biopsy was transrectal (18 cores) or transperineal (24–32 cores) depending on patient tolerance for the first biopsy, prostate volume or MRI findings. A follow-up biopsy was performed after 24 months and subsequently every 3 years until 80 years old or the occurrence of any medical event that impaired life expectancy.Disease progression definition was: increase in GS on biopsy, >2 positive cores at TRUS biopsy or ≥3 positive areas in a TP biopsy or >5 mm per PCa core involved in any case.<a class="elsevierStyleCrossRef" href="#bib0025">5</a> Patients were counselled to abandon AS based on prostate biopsy results or on patient concerns/anxiety.For the present study we included AS patients that strictly met the diagnostic biopsy criteria in our protocol. We excluded cases diagnosed by transurethral resection of prostate (TURP) or adenomectomy, patients lost to follow-up, and diagnosis with TP biopsy. The remaining AS population was 326 patients.Confirmatory biopsy was performed between 6 and 12 months. Among 326 patients, 6 patients underwent active treatment prior to confirmatory biopsy. The remaining 320 patients had confirmatory biopsies. 22 patients did not meet our protocol criteria due to lack of follow-up or progression rejecting active treatment. The final target AS population included 304 patients (Supplementary material Fig. S1).We selected men who underwent RP after initial AS. The cohort was stratified into “per-protocol” or “induced” groups. Secondly, we divided the population based on the indication for RP: <ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005">•Reclassification, upgrading on confirmatory biopsy.</li><li class="elsevierStyleListItem" id="lsti0010">•Progression on follow-up biopsy.</li><li class="elsevierStyleListItem" id="lsti0015">•Patient anxiety without fulfilling progression criteria.</li></ul>Endpoints of studyPrimary endpoint was the overtreatment ratio on the RP cohort based on the presence of insignificant PCa defined by Epstein´s criteria (Gleason < 3 + 4, ≤pT2, pN0-Nx, total tumor volume < 0.5 cc) and Wolters´ criteria (Gleason < 3 + 4, ≤pT2, pN0-Nx, total tumor volume < 2.5 cc and index lesion < 1.3 cc).<a class="elsevierStyleCrossRefs" href="#bib0030">6,7</a>Secondary endpoints were rate of adverse pathological features (≥pT3 and/or Gleason Score ≥ 4 + 3 and/or pN1) and biochemical relapse-free survival (biochemical relapse: PSA ≥ 0.2 ng/mL on two consecutive occasions) on the RP cohort.Statistical analysisIn descriptive analyses, for continuous variables with non-normal distribution, data were presented as median and interquartile range (IQR) and groups were compared using Mann-Whitney U test. Categorical variables were compared using Chi-square test.Kaplan-Meier curves were used to estimate the biochemical relapse-free survival, compared with the log-rank test. The estimate standard error was used to compute the relative 95% confidence intervals (CI) of HR. All statistical analyses were performed using R Statistical Software (version 3.5.3; R Foundation for Statistical Computing, Vienna, Austria). All tests were two-tailed, and a P-value <.05 was considered indicative of a statistically significant association.ResultsOur study cohort included a total of 162 (31%) patients in the induced AS group and 354 (69%) in the per-protocol AS group. Supplementary material Table S1.After exclusions we finally analysed 304 patients on AS protocol. Median follow-up from diagnosis until last RP was 45.7 months (IQR: 26.5–70.3). Median time to confirmatory biopsy was 7.1 months (IQR: 6.3–8.8). <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>142 patients (27% out of 516 patients on AS) received active treatment (focal therapy, n = 8; brachytherapy, n = 16; radiotherapy, n = 10; combination of both brachytherapy and radiotherapy, n = 5; cryotherapy, n = 2; androgen deprivation therapy (ADT), n = 1; RP, n = 100) whilst 162 patients remained on AS (153, 29% out of 516) or were converted to watchful-waiting (9, 2% out of 516). Supplementary material Table S2.Radical prostatectomy following AS protocol descriptiveA total of 100 patients underwent RP, 31 (31%) in the “induced” and 69 (69%) in “per-protocol” AS group. RP was performed due to reclassification in 66 (66%), progression in 18 (18%) and anxiety in 16 (16%) patients.The baseline clinical features on the RP group at PCa diagnosis and following surgery are shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> and Supplementary material Table S3. At diagnosis median age was 64.6 years (IQR: 59.5−68) and median PSA was 5.2 ng/mL (IQR: 3.8−6.5). Median follow-up after RP was 31.4 months (16−54). <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> and Supplementary material Table S3.<elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia>RP specimen’s GS was 3 + 3 in 32 patients (32%), 3 + 4 in 45 (45%), 4 + 3 in 21 (21%), 4 + 5 in 1 (1%) and 5 + 4 in 1 patient (1%). 23% of patients had positive surgical margins (PSM). Positive lymph nodes (N1) were noticed in 5 patients (5%).pT3 ratio was higher among “induced” AS (9 patients out of 31, 29% vs “per-protocol”: 16 patients out of 69, 23%). Median tumor volume was 1.7 mL (IQR: 1.1−3.3) in “induced” AS, compared to 1.3 mL (IQR: 0.6−2.3) in the “per-protocol” cohort (P = .09). 2 patients (out of 31, 6%) with Gleason Score 9 were reported in the “induced” AS group. PSM were more frequent among “induced” AS group (32% compared to 19% of “per-protocol” patients).When stratified based on indication for RP (reclassification, progression or anxiety), PSA pre-RP was significantly higher in the progression group with a median of 8.2 ng/mL, (IQR: 6.9−12, P = .002). Rate of positive lymph nodes (N1) was significantly higher in the progression group (11% compared to 5% in reclassification and 0% in anxiety group, P = .002). A slightly higher proportion of pT3 disease was observed in the progression group (28% vs 26% of the reclassification group), however was not significantly different. 6% of the progression cohort had a Gleason Score of 9 on prostatectomy specimen compared to 1% in the reclassification cohort. Finally, PSM were more frequently reported in the progression subgroup compared to reclassification (28% vs 20%).Insignificant PCa at RP specimen was observed in 7 patients (7%) according to Epstein criteria (3 patients (5%) from the reclassification group and 4 patients (25%) from the anxiety group). When applying Wolters definition, 24 (24%) patients had insignificant PCa (15 patients (23%) from the reclassification group; 3 patients (17%) from the progression group and 6 patients (37%) from the anxiety group).Adverse pathological features rate was 36%, no statistically significant differences were observed between AS groups (“induced”, n = 13 (42%) vs “per-protocol”, n = 23 (33%), P = .546) or indications for RP (reclassification, n = 25 (38%) vs progression, n = 8 (44%) vs anxiety, n = 3 (19%), P = .256).Biochemical recurrence free survival outcomesMedian follow-up from diagnosis until last RP was 48.3 months (IQR: 32.4−70). 3 year-biochemical recurrence free survival (BRFS) post RP was 85.4% (95% CI: 78.3–93.1). There were no significant differences in BRFS between AS groups (P = .5) or amongst indications for RP (P = .62). <a class="elsevierStyleCrossRefs" href="#fig0005">Figs. 1–3</a>.<elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia>DiscussionDespite PCa AS being supported by major society guidelines, there is still hesitation surrounding its uptake.<a class="elsevierStyleCrossRefs" href="#bib0050">10,11</a> The rational for it relies on several reasons such as heterogeneity among AS protocols selection criteria, timing of follow-up and indications for active treatment.<a class="elsevierStyleCrossRef" href="#bib0060">12</a> Consequently, there is an increased need to reach a consensus for AS strategies.<a class="elsevierStyleCrossRefs" href="#bib0065">13,14</a> Of note, patient selection and further management while on AS would be implemented in the near future by optimizing mpMRI and use of biomarkers (e.g. Prostate Health Index, PHI; Prostate Cancer Antigen 3, PCA3), encouraging a personalized precision medicine.<a class="elsevierStyleCrossRefs" href="#bib0075">15–17</a>In the current study, 516 patients were included in our AS cohort, RP was performed during follow-up in 100 patients (19%). In line with previous similar publication reporting outcomes of RP within AS protocols,<a class="elsevierStyleCrossRefs" href="#bib0090">18–21</a> a third of the patients included in AS protocol do not fulfil strict inclusion criteria.In patients who underwent RP after “induced” AS, pathological characteristics of surgical specimen as well as biochemical outcomes during follow-up were slightly worse. These findings suggest that we should be cautious in broadening the inclusion criteria. Additionally, patients outside of the criteria who wish to be managed with AS should be informed of the potential for increased risk of progression on AS.The most frequent reason to perform RP after AS was reclassification (66%). RP was performed due to patient anxiety in 16 cases (16%) in our population, lower compared to Hong et al. analysis<a class="elsevierStyleCrossRef" href="#bib0100">20</a> and the last update from the PRIAS study,<a class="elsevierStyleCrossRef" href="#bib0110">22</a> which were 25.3% and 29% respectively; but higher than Bul et al. report (12.7%).<a class="elsevierStyleCrossRef" href="#bib0045">9</a>Median follow-up after RP was 31.4 months (16−54), shorter than other series.<a class="elsevierStyleCrossRefs" href="#bib0100">20,21</a> Biochemical relapse was experienced by 15% of the RP cohort, without significant differences between groups. This is comparable with the Göteborg group who reported a PSA relapse in 19% of their cohort.<a class="elsevierStyleCrossRef" href="#bib0105">21</a> In contrast, the Memorial Sloan Kettering Cancer Center group reported recurrence in only 1 patient (1.5%), however, they did not include patients reclassified on confirmatory biopsy.In their long term follow-up study, Klotz et al. reported a biochemical-relapse free survival rate after RP at 5, 10 and 15 years of 80%, 65% and 54% respectively.<a class="elsevierStyleCrossRef" href="#bib0115">23</a> Similarly, in our cohort, we estimate that the biochemical relapse-free survival after RP at 5 years will be 83.6% (95% CI: 76%–92%). However, a longer follow-up is required to compare results between Klotz and our cohort.One of the principal objectives of AS is to avoid overtreatment. However, patients on AS who subsequently undergo radical therapy may still be overtreated. Several groups have reported potentially insignificant PCa found in RP specimens after AS. Duffield et al. found that 27% of tumors were organ confined, dominant nodule <0.5 cm3 with no Gleason pattern 4 or 5.<a class="elsevierStyleCrossRef" href="#bib0090">18</a> In their prospective observational study, Bul et al. reported that 28% had no Gleason pattern 4 or 5 and no extracapsular extension, however no tumor volume was specified.<a class="elsevierStyleCrossRef" href="#bib0045">9</a> Hong et al. observed 30.4% patients with organ confined disease and no Gleason pattern 4 or 5.<a class="elsevierStyleCrossRef" href="#bib0100">20</a>The Epstein criteria for insignificant PCa have been globally accepted since first published in 1993.<a class="elsevierStyleCrossRefs" href="#bib0120">24,25</a> However, in 2011, Wolters et al.<a class="elsevierStyleCrossRef" href="#bib0035">7</a> published less strict criteria. More recently, Kryvenko and Epstein<a class="elsevierStyleCrossRef" href="#bib0030">6</a> discussed in their study the definitions of insignificant tumor volume in GS 6, concluding that an increase in volume above 0.5 cm3 was associated in their cohort with a significant increase in likelihood of extra-prostatic extension and positive surgical margins. When using Epstein´s criteria, we found an insignificant PCa ratio of 7%, whereas for Wolters´ definition, the ratio was higher at 24%. In our cohort, for both definitions, this ratio was higher among the anxiety group, in whom RP was performed exclusively based on patient wishes.36 patients in our cohort (36%) demonstrated adverse pathological features on RP specimen histology, the highest proportion being among the progression cohort (not statistically significant). Positive lymph node rates were significantly greater for disease progression RP compared with reclassification and anxiety. We were unable to find significant differences between “induced” vs “per-protocol” AS, however the ratio of adverse pathological features was higher among the induced AS cohort (42% vs 33%). In comparison, Bul et al.<a class="elsevierStyleCrossRef" href="#bib0045">9</a> reported unfavorable RP results (pT3-4 and/or GS ≥ 4 + 3) in 29% of cases. Whilst our population had a slightly higher proportion of patients with adverse features on histopathology, this may be contributed by the inclusion of patients not fulfilling the inclusion criteria.The present study has several limitations. Firstly, it is a retrospective study of a single institution´s experience. Furthermore, whilst our numbers are comparable to previous studies assessing RP following AS,<a class="elsevierStyleCrossRefs" href="#bib0090">18–21</a> potentially our cohort was too small and lacked the power to identify clinical or pathological factors at diagnosis significantly associated with the presence of insignificant PCa or adverse pathological features. Median follow-up was less than 5 years compared to other series. Finally, in all AS series patient anxiety, as a subjective component, makes comparison of outcomes difficult due to lack of standardization.ConclusionThe small number of patients who undergo RP following AS for insignificant PCa suggests that AS limits overtreatment of low-risk PCa. Furthermore, two-thirds of our patients do not demonstrate adverse pathological features suggesting RP can be considered a safe treatment strategy after failing AS. Future studies should aim to further clarify selection criteria for AS whilst attempting to achieve a consensus among protocols in order to globalize the uptake of AS strategy as a management option in selected PCa patients.FundingThis research has not received specific funding from public sector agencies, commercial sector or non-profit entities.Conflicts of interestsThe authors declare that they have no conflicts of interests." "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:3 [ "identificador" => "xres1519035" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1377538" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1519034" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1377537" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Methods" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Inclusion criteria definition for AS cohort" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "AS protocol within our institution" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Endpoints of study" ] 3 => array:2 [ "identificador" => "sec0030" "titulo" => "Statistical analysis" ] ] ] 6 => array:3 [ "identificador" => "sec0035" "titulo" => "Results" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0040" "titulo" => "Radical prostatectomy following AS protocol descriptive" ] 1 => array:2 [ "identificador" => "sec0045" "titulo" => "Biochemical recurrence free survival outcomes" ] ] ] 7 => array:2 [ "identificador" => "sec0050" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0055" "titulo" => "Conclusion" ] 9 => array:2 [ "identificador" => "sec0060" "titulo" => "Funding" ] 10 => array:2 [ "identificador" => "sec0065" "titulo" => "Conflicts of interests" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2020-06-15" "fechaAceptado" => "2020-09-14" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1377538" "palabras" => array:5 [ 0 => "Active surveillance" 1 => "Disease progression" 2 => "Prostate" 3 => "Prostatectomy" 4 => "Prostatic neoplasms" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1377537" "palabras" => array:5 [ 0 => "Vigilancia activa" 1 => "Progresión de la enfermedad" 2 => "Próstata" 3 => "Prostatectomía" 4 => "Neoplasias prostáticas" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "ObjectiveDetermine whether our institution´s active surveillance (AS) protocol is a suitable strategy to minimise prostate cancer overtreatment. Material and MethodsRetrospective analysis of 516 patients on AS after prostate cancer diagnosis. Population divided into “per-protocol” vs “induced” AS depending on fulfilment of protocol´s inclusion criteria. Radical prostatectomies after AS were selected and stratified based on: reclassification, progression or patient anxiety. Clinicopathological features and biochemical relapse-free survival were studied. Primary endpoint was overtreatment ratio based on the presence of insignificant prostate cancer and adverse pathological features in the surgical specimen. Kaplan-Meier curves were used to estimate the biochemical relapse-free survival and compared with log-rank test. Results304 patients fulfilled inclusion criteria; 100 proceeded to radical prostatectomy (31% “induced”, 69% “per-protocol” AS). Surgery indications were reclassification, progression and anxiety in 66%, 18% and 16% of patients respectively. Rate of positive lymph nodes was higher in the progression group (11%) compared to reclassification and anxiety (5% and 0% respectively, P = .002). Positive surgical margins were more frequently reported in the progression cohort compared to reclassification (28% vs 20%). Median follow-up from diagnosis until last radical prostatectomy was 48.3 months (32.4−70). 3 year biochemical relapse-free survival in the salvage radical prostatectomy was 85.4% (95 CI 78.3–93.2). Insignificant cancer was noticed in 7% of patients (Epstein´s vs 24% Wolters´ criteria). Rate of patients with adverse pathological features was 36%. ConclusionsThe majority of patients who underwent salvage surgery after AS were not overtreated. Radical prostatectomy should be considered a safe rescue treatment." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "ObjetivoDeterminar si el protocolo de vigilancia activa (VA) de nuestra institución es una estrategia adecuada para minimizar el sobretratamiento del cáncer de próstata. Material y métodosAnálisis retrospectivo de 516 pacientes en VA tras el diagnóstico de cáncer de próstata. La población se dividió en VA “por protocolo” vs. “inducida” dependiendo del cumplimiento de los criterios de inclusión del protocolo. Las prostatectomías radicales después de la VA fueron seleccionadas y estratificadas en base a: reclasificación, progresión o ansiedad del paciente. Se estudiaron las características clínico-patológicas y la supervivencia libre de recidiva bioquímica. La variable principal del estudio fue el porcentaje de sobretratamiento con relación a la presencia de un cáncer de próstata insignificante y de características patológicas adversas en la pieza quirúrgica. Se utilizaron las curvas de Kaplan-Meier para estimar la supervivencia libre de recidiva bioquímica y se compararon con la prueba log-rank. Resultados304 pacientes cumplieron los criterios de inclusión; 100 procedieron a una prostatectomía radical (31% “VA inducida”, 69% “VA por protocolo” VA). Las indicaciones para la cirugía fueron el reclasificación, la progresión y la ansiedad de los pacientes (66%, 18% y 16%, respectivamente). La tasa de ganglios linfáticos positivos fue mayor en el grupo de progresión (11%) en comparación con la reclasificación y la ansiedad (5% y 0% respectivamente, P = ,002). Los márgenes quirúrgicos positivos fueron más frecuentes en la cohorte de progresión en comparación con la reclasificación (28% vs. 20%). La media de seguimiento desde el diagnóstico hasta la última prostatectomía radical fue de 48,3 meses (32,4–70). La supervivencia libre de recidiva bioquímica a los 3 años en la prostatectomía radical de rescate fue del 85,4% (95 CI 78,3–93,2). Se observó un cáncer insignificante en el 7% de los pacientes (criterio de Epstein vs. 24% de Wolters). La tasa de pacientes con características patológicas adversas fue del 36%. ConclusionesLa mayoría de los pacientes que se sometieron a cirugía de rescate después de la VA no recibieron sobretratamiento. La prostatectomía radical debería ser considerada un tratamiento de rescate seguro." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Polo Alonso E, Ramírez-Backhaus M, Wei G, Mascarós JM, Aragón Rodriguez F, Gómez-Ferrer Á, et al. ¿La vigilancia activa evita el sobretratamiento en el cáncer de próstata? Lecciones aprendidas de prostatectomías radicales de rescate. Actas Urol Esp. 2021;45:373–382." ] ] "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "The following is Supplementary data to this article:<elsevierMultimedia ident="upi0005"></elsevierMultimedia>" "etiqueta" => "Appendix A" "titulo" => "Supplementary data" "identificador" => "sec0075" ] ] ] ] "multimedia" => array:7 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2349 "Ancho" => 2508 "Tamanyo" => 252837 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Biochemical recurrence-free survival rates of patients undergoing RP after AS. After a median follow-up of 48.3 months (IQR: 32.4–70) from diagnosis until last RP, the 3 year-BRFS post RP was 85.4% (95% CI: 78.3–93.1). RP, radical prostatectomy; IQR, interquartile range; BRFS, biochemical recurrence free survival." ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 2956 "Ancho" => 2508 "Tamanyo" => 376822 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Kaplan-Meier Curves depicting the Biochemical Recurrence-Free survival over time stratified among “induced AS” and “per-protocol AS” groups. The 3 year-BRFS post RP was 82.9% (95% CI: 70.3–97.8) in “induced AS” group and 86.6% (95% CI: 78.3–95.8) in “per-protocol AS” group. No significant differences in BRFS between AS groups (P = .5). AS, active surveillance; BRFS, biochemical recurrence free survival; RP, radical prostatectomy; CI, confidence interval." ] ] 2 => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 2922 "Ancho" => 2508 "Tamanyo" => 367412 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Kaplan-Meier Curves depicting the Biochemical Recurrence-Free survival over time stratified among indications for RP after AS (reclassification and progression). The 3 year-BRFS post RP was 87.1% (95% CI: 78.3–96.7) in “reclassification” group and 83.3% (95% CI: 67.8–100) in “progression” group. No significant differences in BRFS amongst indications for RP (P = .62). AS, active surveillance; BRFS, biochemical recurrence free survival; RP, radical prostatectomy; CI, confidence interval." ] ] 3 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0020" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "Bolded values indicate statistical significance (P < .05).BMI, body mass index; ASA, American Society of Anesthesiologists; IQR, interquartile range; GS, Gleason score; AS, active surveillance." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variable \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Induced AS \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Per-protocol AS \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">P-value \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">304 (100%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">78 (26%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">226 (74%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PSA at diagnosis (ng/mL), Median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.9 (3.7−6.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (3.7−7.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.9 (3.7−6.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.240 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age at diagnosis (years), Median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">64.8 (59.8−69.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">67 (62.6−70.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">64.2 (59−69.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.009 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Prostate volume at diagnosis (ml), Median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">40 (29.1−52.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">37.2 (25.5−45) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">40 (30.1−55.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.043 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PSA density, Median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.13 (0.09−0.19) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.15 (0.10−0.21) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.12 (0.09−0.17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.012 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">BMI at diagnosis, Median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27.1 (24.6−29.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27.7 (24.7−29.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27 (24.6−29) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.243 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ASA risk at diagnosis, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.363 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26 (14) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (19) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 (12) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Charlson index at diagnosis, Median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.8 (0−2.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.7 (0−2.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.8 (0.00−2.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.650 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">GS at diagnosis, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 + 3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">284 (94) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">62 (80) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">222 (98) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 + 4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 (5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 (15) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 + 3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2608388.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Clinical and pathological characteristics of patients following the AS protocol after application of exclusion criteria." ] ] 4 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0025" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "Note: bold values indicate statistical significance (P < .05).AS, Active surveillance; PSA, Prostate specific antigen; IQR, Interquartile range; GS, Gleason score; RP, Radical prostatectomy; PCa, Prostate cancer." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variable \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Induced AS \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Per-protocol AS \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">P-value \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Reclassification \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Progression \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Anxiety \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">P-value \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100 (100%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">31 (31%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">69 (69%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">66 (66%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18 (18%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 (16%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PSA at diagnosis, Median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.2 (3.8−6.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.1 (4−7.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.2 (3.7−6.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.352 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.2 (3.7−6.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.2 (4.2−6.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.8 (4−7.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.825 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age at diagnosis (years), Median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">64.6 (59.5−68) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">64.2 (59.5−66.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">65 (60−69.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.300 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">65.6 (60.8−70) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">64.7 (56.7−66.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">61.2 (57.5−62.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.022 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PSA density, Median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.15 (0.11−0.19) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.16 (0.12−0.20) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.13 (0.11−0.19) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.222 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.16 (0.11−0.19) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.13 (0.12−0.15) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.16 (0.12−0.21) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.280 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Charlson index, Median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.9 (0−2.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.9 (0.7−2.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.9 (0−2.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.900 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.9 (0−2.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (0−2.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.1 (0.9−2.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.811 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PSA pre-RP, Median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.6 (3.7−7.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.9 (4−8.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.4 (3.6−7.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.423 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.1 (3.5−7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.2 (6.9−12) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.2 (4.1−7.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.002 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age pre-RP (years), Median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">66.9 (61.2−70.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">66 (61.2−68.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">67.7 (61.4−71.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.396 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">67.5 (62.4−71.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">68.9 (61.6−70.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">62.7 (59.5−64.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.041 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Follow-up (months) since diagnosis, Median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">48.3 (32.4−70) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">51.3 (31.7−78.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">46.4 (33.2−67.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.452 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">39.5 (25.8−60.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">61.4 (41.8−77.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">77.4 (55.2−85.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Follow-up (months) since RP, Median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">31.4 (16−54) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">38.2 (18.3−55) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30.6 (14.2−51.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.331 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30.6 (16.4−50.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19.2 (5.3−31.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">66 (44.2−77) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Biochemical relapse, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15 (15) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (19) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (13) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.607 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (11) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (31) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.113 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2608389.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Clinical characteristics of patients with RP following AS protocol." ] ] 5 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0030" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "AS, Active surveillance; PSA, Prostate specific antigen; IQR: Interquartile range; GS, Gleason score; RP: Radical prostatectomy; pT: Pathological stage; PCa, Prostate cancer; PSM, Positive surgical margins." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variable \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Induced AS \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Per-protocol AS \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">P-value \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Reclassification \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Progression \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Anxiety \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">P-value \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100 (100%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">31 (31%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">69 (69%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">66 (66%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18 (18%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 (16%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">pT, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.708 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.808 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">pT2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">75 (75) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22 (71) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">53 (77) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">49 (74) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (72) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (81) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">pT3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25 (25) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (29) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 (23) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 (26) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (28) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (19) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Tumor volume (ml), Median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.4 (0.7−2.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.7 (1.1−3.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.3 (0.6−2.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.090 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.5 (0.8−2.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.4 (1.1−3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.8 (0.5−1.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.040 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">GS at diagnosis, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.017 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.615 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 + 3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">92 (92) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25 (81) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">67 (97) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">60 (91) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 (87.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 + 4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (16) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (12.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 + 3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">GS surgical specimen, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.317 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.178 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 + 3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">32 (32) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (29) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23 (33) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21 (32) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (22) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (44) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 + 4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">45 (45) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (42) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">32 (47) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">31 (47) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (33) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (50) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 + 3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21 (21) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (23) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 (20) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (20) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (39) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PSM, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23 (23) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (32) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (19) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.223 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (20) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (28) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (31) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.534 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Positive lymph nodes, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (10) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.352 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (11) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.002 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Adverse Pathological Features, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">36 (36) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (42) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23 (33) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.546 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25 (38) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (44) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (19) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.256 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Epstein Criteria for insignificant PCa, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.57 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (25) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.007 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Wolters Criteria for insignificant PCa, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24 (24) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (23) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 (25) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15 (23) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (37) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.335 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2608390.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Pathological characteristics of patients with RP following AS protocol." ] ] 6 => array:5 [ "identificador" => "upi0005" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:2 [ "fichero" => "mmc1.pdf" "ficheroTamanyo" => 238914 ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:25 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Active surveillance for prostate cancer: overview and update" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "L. Klotz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11864-012-0221-5" "Revista" => array:6 [ "tituloSerie" => "Curr Treat Options Oncol." "fecha" => "2013" "volumen" => "14" "paginaInicial" => "97" "paginaFinal" => "108" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23318986" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Contemporary trends in low risk prostate cancer: risk assessment and treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.R. Cooperberg" 1 => "J.M. Broering" 2 => "P.W. Kantoff" 3 => "P.R. Carroll" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.juro.2007.03.135" "Revista" => array:7 [ "tituloSerie" => "J Urol." "fecha" => "2007" "volumen" => "178" "paginaInicial" => "S14" "paginaFinal" => "9" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17644125" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S147020451930333X" "estado" => "S300" "issn" => "14702045" ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Contemporary use of initial active surveillance among men in Michigan with low-risk prostate cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P.R. Womble" 1 => "J.E. Montie" 2 => "Z. Ye" 3 => "S.M. Linsell" 4 => "B.R. Lane" 5 => "D.C. Miller" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.eururo.2014.08.024" "Revista" => array:6 [ "tituloSerie" => "Eur Urol." "fecha" => "2015" "volumen" => "67" "paginaInicial" => "44" "paginaFinal" => "50" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25159890" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Predictors of pathologic progression on biopsy among men on active surveillance for localized prostate cancer: the value of the pattern of surveillance biopsies" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K.C. Cary" 1 => "J.E. Cowan" 2 => "M. Sanford" 3 => "K. Shinohara" 4 => "N. Perez" 5 => "J.M. Chan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.eururo.2013.08.060" "Revista" => array:6 [ "tituloSerie" => "Eur Urol." "fecha" => "2014" "volumen" => "66" "paginaInicial" => "337" "paginaFinal" => "342" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24035632" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Información obligatoria que debe conocer un paciente con cáncer de próstata candidato a vigilancia activa" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Rubio-Briones" 1 => "I. Iborra" 2 => "M. Ramírez" 3 => "A. Calatrava" 4 => "A. Collado" 5 => "J. Casanova" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.acuro.2014.02.007" "Revista" => array:6 [ "tituloSerie" => "Actas Urol Esp." "fecha" => "2014" "volumen" => "38" "paginaInicial" => "559" "paginaFinal" => "565" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24636075" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Definition of insignificant tumor volume of Gleason Score 3 D 3 [ 6 ( Grade Group 1 ) prostate cancer at radical prostatectomy d is it time to increase the threshold?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "O.N. Kryvenko" 1 => "J.I. Epstein" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.juro.2016.06.013" "Revista" => array:6 [ "tituloSerie" => "J Urol." "fecha" => "2016" "volumen" => "196" "paginaInicial" => "1664" "paginaFinal" => "1669" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27291653" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A critical analysis of the tumor volume threshold for clinically insignificant prostate cancer using a data set of a randomized screening trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:7 [ 0 => "T. Wolters" 1 => "M.J. Roobol" 2 => "P.J. van Leeuwen" 3 => "R.C.N. van den Bergh" 4 => "R.C.N. van den Bergh" 5 => "R.F. Hoedemaeker" 6 => "G.J.L.H. van Leenders" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.juro.2010.08.082" "Revista" => array:6 [ "tituloSerie" => "J Urol." "fecha" => "2011" "volumen" => "185" "paginaInicial" => "121" "paginaFinal" => "125" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21074212" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A 17-gene assay to predict prostate cancer aggressiveness in the context of gleason grade heterogeneity, tumor multifocality, and biopsy undersampling" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E.A. Klein" 1 => "M.R. Cooperberg" 2 => "C. Magi-Galluzzi" 3 => "J.P. Simko" 4 => "S.M. Falzarano" 5 => "T. Maddala" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.eururo.2014.05.004" "Revista" => array:7 [ "tituloSerie" => "Eur Urol." "fecha" => "2014" "volumen" => "66" "paginaInicial" => "550" "paginaFinal" => "560" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24836057" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0022202X18322930" "estado" => "S300" "issn" => "0022202X" ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Active surveillance for low-risk prostate cancer worldwide: the PRIAS study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Bul" 1 => "X. Zhu" 2 => "R. Valdagni" 3 => "T. Pickles" 4 => "Y. Kakehi" 5 => "A. Rannikko" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Eur Urol." "fecha" => "2013" "volumen" => "63" "paginaInicial" => "597" "paginaFinal" => "603" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "EAU-EANM-ESTRO-ESUR-SIOG Guidelines on Prostate Cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "N. Mottet" 1 => "R.C.N. van den Bergh" 2 => "E. Briers" 3 => "P. Cornford" 4 => "M. De Santis" 5 => "S. Fanti" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:1 [ "fecha" => "2019" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Active surveillance for the management of localized prostate cancer: guideline recommendations" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C. Morash" 1 => "R. Tey" 2 => "C. Agbassi" 3 => "L. Klotz" 4 => "T. McGowan" 5 => "J. Srigley" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5489/cuaj.2806" "Revista" => array:5 [ "tituloSerie" => "Can Urol Assoc J." "fecha" => "2015" "volumen" => "9" "paginaInicial" => "171" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26225165" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Semantics in active surveillance for men with localized prostate cancer—results of a modified Delphi consensus procedure" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S.M. Bruinsma" 1 => "M.J. Roobol" 2 => "P.R. Carroll" 3 => "L. Klotz" 4 => "T. Pickles" 5 => "C.M. Moore" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/nrurol.2017.26" "Revista" => array:6 [ "tituloSerie" => "Nat Rev Urol." "fecha" => "2017" "volumen" => "14" "paginaInicial" => "312" "paginaFinal" => "322" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28290462" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0065" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Study protocol for the DETECTIVE study: an international collaborative study to develop consensus statements for deferred treatment with curative intent for localised prostate cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T.B.L. Lam" 1 => "S. MacLennan" 2 => "K. Plass" 3 => "P.-P.M. Willemse" 4 => "M.D. Mason" 5 => "P. Cornford" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.eururo.2018.11.009" "Revista" => array:6 [ "tituloSerie" => "Eur Urol." "fecha" => "2019" "volumen" => "75" "paginaInicial" => "699" "paginaFinal" => "702" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30473433" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0070" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Active surveillance for low-risk prostate cancer : The European Association of Urology Position in 2018" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Briganti" 1 => "N. Fossati" 2 => "J.W.F. Catto" 3 => "P. Cornford" 4 => "F. Montorsi" 5 => "N. Mottet" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.eururo.2018.06.008" "Revista" => array:6 [ "tituloSerie" => "Eur Urol." "fecha" => "2018" "volumen" => "74" "paginaInicial" => "357" "paginaFinal" => "368" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29937198" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0075" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "In-parallel comparative evaluation between multiparametric magnetic resonance imaging, prostate cancer antigen 3 and the prostate health index in predicting pathologically confirmed significant prostate cancer in men eligible for active surveillance" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Porpiglia" 1 => "F. Cantiello" 2 => "S. De Luca" 3 => "M. Manfredi" 4 => "A. Veltri" 5 => "F. Russo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/bju.13318" "Revista" => array:6 [ "tituloSerie" => "BJU Int." "fecha" => "2016" "volumen" => "118" "paginaInicial" => "527" "paginaFinal" => "534" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26350955" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0080" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prognostic biomarkers used for localised prostate cancer management: a systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P.J. Lamy" 1 => "Y. Allory" 2 => "A.S. Gauchez" 3 => "B. Asselain" 4 => "P. Beuzeboc" 5 => "P. de Cremoux" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.euf.2017.02.017" "Revista" => array:7 [ "tituloSerie" => "Eur Urol Focus." "fecha" => "2018" "volumen" => "4" "paginaInicial" => "790" "paginaFinal" => "803" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28753865" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0190962217322028" "estado" => "S300" "issn" => "01909622" ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0085" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prostate Health Index and multiparametric magnetic resonance imaging to predict prostate cancer grade reclassification in active surveillance" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Z.R. Schwen" 1 => "M. Mamawala" 2 => "J.J. Tosoian" 3 => "S.C. Druskin" 4 => "A.E. Ross" 5 => "L.J. Sokoll" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/bju.15101" "Revista" => array:6 [ "tituloSerie" => "BJU Int." 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"fecha" => "2018" "volumen" => "200" "paginaInicial" => "779" "paginaFinal" => "785" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29730198" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0110" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A decade of active surveillance in the PRIAS study: an update and evaluation of the criteria used to recommend a switch to active treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L.P. Bokhorst" 1 => "R. Valdagni" 2 => "A. Rannikko" 3 => "Y. Kakehi" 4 => "T. Pickles" 5 => "C.H. Bangma" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.eururo.2016.06.007" "Revista" => array:7 [ "tituloSerie" => "Eur Urol." "fecha" => "2016" "volumen" => "70" "paginaInicial" => "954" "paginaFinal" => "960" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27329565" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0022202X19325448" "estado" => "S300" "issn" => "0022202X" ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0115" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Long-term follow-up of a large active surveillance cohort of patients with prostate cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L. Klotz" 1 => "D. Vesprini" 2 => "P. Sethukavalan" 3 => "V. Jethava" 4 => "L. Zhang" 5 => "S. Jain" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1200/JCO.2014.55.1192" "Revista" => array:6 [ "tituloSerie" => "J Clin Oncol." "fecha" => "2015" "volumen" => "33" "paginaInicial" => "272" "paginaFinal" => "277" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25512465" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0120" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Is tumor volume an independent predictor of progression following radical prostatectomy? A multivariate analysis of 185 clinical stage B adenocarcinomas of the prostate with 5 years of followup" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.I. Epstein" 1 => "M. Carmichael" 2 => "A.W. Partin" 3 => "P.C. Walsh" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/s0022-5347(17)36421-2" "Revista" => array:7 [ "tituloSerie" => "J Urol." 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Does active surveillance avoid overtreatment in prostate cancer? Lessons learned from salvage radical prostatectomies

¿La vigilancia activa evita el sobretratamiento en el cáncer de próstata? Lecciones aprendidas de prostatectomías radicales de rescate

E. Polo Alonsoa,

Corresponding author

epoloalonso@gmail.com

Corresponding author.

, M. Ramírez-Backhausa, G. Weib,c, J.M. Mascarósa, F. Aragón Rodrigueza, Á. Gómez-Ferrera, A. Colladoa, A. Calatrava Fonsd, J. Rubio-Brionesa

a Departamento de Urología, Fundación Instituto Valenciano de Oncología, Valencia, Spain

b Department of Surgery, Austin Health, The University of Melbourne, Melbourne, Victoria, Australia

c Young Urology Researchers Organisation (YURO), Melbourne, Victoria, Australia

d Departamento de Patología, Fundacion Instituto Valenciano de Oncologia, Valencia, Spain

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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Biochemical recurrence-free survival rates of patients undergoing RP after AS&#46; After a median follow-up of 48&#46;3 months &#40;IQR&#58; 32&#46;4&#8211;70&#41; from diagnosis until last RP&#44; the 3 year-BRFS post RP was 85&#46;4&#37; &#40;95&#37; CI&#58; 78&#46;3&#8211;93&#46;1&#41;&#46;</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">RP&#44; radical prostatectomy&#59; IQR&#44; interquartile range&#59; BRFS&#44; biochemical recurrence free survival&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The availability of prostate specific antigen &#40;PSA&#41; screening for prostate cancer &#40;PCa&#41; has been widespread in recent decades&#44; resulting in a considerable decrease in cancer related mortality in Western countries&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> However&#44; its prevalence has led to an increase in the detection of low risk PCa<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> and&#44; subsequently&#44; the potential to overtreatment&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Almost one-third of patients diagnosed will have a low or very low risk of PCa progression&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> As a result&#44; active surveillance &#40;AS&#41; has been suggested as an alternative management strategy and involves close monitoring of low risk disease without offering radical treatment as an initial option&#46; Ultimately&#44; AS aims to avoid harmful overtreatment when there is no significant survival benefit&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Whilst the concept of AS appears attractive&#44; its uptake has occurred slowly&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Various factors have contributed to this hesitation including lack of clear guidelines surrounding patient selection&#44; follow-up regimen and indications for radical treatment&#46; In addition&#44; PCa may be under-classified on prostate biopsy which may result in delaying active treatment&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> For this reason&#44; it is important that any AS regimen takes into consideration its patient population and aims to standardise prostate biopsies&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">In this study&#44; we analyse the outcomes of patients who underwent radical prostatectomy &#40;RP&#41; after initially following our AS protocol&#46; We studied the overtreatment ratio in this cohort based on different pathological criteria&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#8211;8</span></a> We aimed to determine whether AS&#44; using our institution protocol&#44; is an appropriate strategy to minimize PCa overtreatment&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">We retrospectively reviewed our center&#8217;s PCa Database between January 1994 and September 2018&#46; A total of 3748 PCa patients are included in the database&#44; 516 patients &#40;14&#37;&#41; underwent AS after localized initial PCa diagnosis&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Inclusion criteria definition for AS cohort</span><p id="par0030" class="elsevierStylePara elsevierViewall">Our inclusion criteria for AS were based on the PRIAS study&#44;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> with some minor modifications&#58; PSA&#160;&#8804;&#160;10&#160;ng&#47;mL&#44; prostate biopsy Gleason score &#40;GS&#41;&#160;&#8804;&#160;3&#160;&#43;&#160;3 &#40;we accepted GS 3&#160;&#43;&#160;4 in patients older than 70 years&#41;&#44; clinical stage T1a-b-c&#44; maximum number of positive biopsy cores of 2 in 10&#8211;12 cores following transrectal ultrasound guided &#40;TRUS&#41; prostate biopsy and a maximum of 3 cores and less than 3 positive areas in a transperineal &#40;TP&#41; approach with prostate sector mapping&#160;&#177;&#160;targeted biopsies&#46; When positive cores were taken on targeted biopsy and the corresponding area on the mapping template&#44; we considered these to be the same affected area&#46; Presence of less than 5&#160;mm of PCa in any core is also needed&#46; Biopsies were assessed for quality&#44; at least 10 cores required to be taken and reviewed by a specialized uro-pathologist&#46; Biopsies not meeting quality criteria were repeated&#46; Other inclusion criteria comprised life expectancy more than 10 years&#44; age less than 80 at time of diagnosis and ability to understand the AS protocol and provide consent&#46; Patients who fulfilled the above criteria were considered &#8220;per-protocol AS&#8221; group&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Additionally&#44; in our AS cohort there were patients who did not fulfil rigid inclusion criteria&#46; However&#44; they were included for other reasons &#40;e&#46;g&#46; patient wishes or the preferential management of other conditions&#41;&#46; These patients were considered &#8220;induced AS&#8221; group in our study&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">AS protocol within our institution</span><p id="par0040" class="elsevierStylePara elsevierViewall">It included a confirmatory biopsy within 6&#8211;12 months after diagnosis&#44; 1&#46;5&#160;T multiparametric Magnetic Resonance Imaging &#40;mpMRI&#41; performed as guidance&#46; Confirmatory prostate biopsy was transrectal &#40;18 cores&#41; or transperineal &#40;24&#8211;32 cores&#41; depending on patient tolerance for the first biopsy&#44; prostate volume or MRI findings&#46; A follow-up biopsy was performed after 24 months and subsequently every 3 years until 80 years old or the occurrence of any medical event that impaired life expectancy&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Disease progression definition was&#58; increase in GS on biopsy&#44; &#62;2 positive cores at TRUS biopsy or &#8805;3 positive areas in a TP biopsy or &#62;5&#160;mm per PCa core involved in any case&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Patients were counselled to abandon AS based on prostate biopsy results or on patient concerns&#47;anxiety&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">For the present study we included AS patients that strictly met the diagnostic biopsy criteria in our protocol&#46; We excluded cases diagnosed by transurethral resection of prostate &#40;TURP&#41; or adenomectomy&#44; patients lost to follow-up&#44; and diagnosis with TP biopsy&#46; The remaining AS population was 326 patients&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Confirmatory biopsy was performed between 6 and 12 months&#46; Among 326 patients&#44; 6 patients underwent active treatment prior to confirmatory biopsy&#46; The remaining 320 patients had confirmatory biopsies&#46; 22 patients did not meet our protocol criteria due to lack of follow-up or progression rejecting active treatment&#46; The final target AS population included 304 patients &#40;Supplementary material Fig&#46; S1&#41;&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">We selected men who underwent RP after initial AS&#46; The cohort was stratified into &#8220;per-protocol&#8221; or &#8220;induced&#8221; groups&#46; Secondly&#44; we divided the population based on the indication for RP&#58; <ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">&#8226;</span><p id="par0065" class="elsevierStylePara elsevierViewall">Reclassification&#44; upgrading on confirmatory biopsy&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">&#8226;</span><p id="par0070" class="elsevierStylePara elsevierViewall">Progression on follow-up biopsy&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">&#8226;</span><p id="par0075" class="elsevierStylePara elsevierViewall">Patient anxiety without fulfilling progression criteria&#46;</p></li></ul></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Endpoints of study</span><p id="par0080" class="elsevierStylePara elsevierViewall">Primary endpoint was the overtreatment ratio on the RP cohort based on the presence of insignificant PCa defined by Epstein&#180;s criteria &#40;Gleason&#160;&#60;&#160;3&#160;&#43;&#160;4&#44; &#8804;pT2&#44; pN0-Nx&#44; total tumor volume&#160;&#60;&#160;0&#46;5&#160;cc&#41; and Wolters&#180; criteria &#40;Gleason&#160;&#60;&#160;3&#160;&#43;&#160;4&#44; &#8804;pT2&#44; pN0-Nx&#44; total tumor volume&#160;&#60;&#160;2&#46;5&#160;cc and index lesion&#160;&#60;&#160;1&#46;3&#160;cc&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#44;7</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">Secondary endpoints were rate of adverse pathological features &#40;&#8805;pT3 and&#47;or Gleason Score&#160;&#8805;&#160;4&#160;&#43;&#160;3 and&#47;or pN1&#41; and biochemical relapse-free survival &#40;biochemical relapse&#58; PSA&#160;&#8805;&#160;0&#46;2&#160;ng&#47;mL on two consecutive occasions&#41; on the RP cohort&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Statistical analysis</span><p id="par0090" class="elsevierStylePara elsevierViewall">In descriptive analyses&#44; for continuous variables with non-normal distribution&#44; data were presented as median and interquartile range &#40;IQR&#41; and groups were compared using Mann-Whitney <span class="elsevierStyleItalic">U</span> test&#46; Categorical variables were compared using Chi-square test&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Kaplan-Meier curves were used to estimate the biochemical relapse-free survival&#44; compared with the log-rank test&#46; The estimate standard error was used to compute the relative 95&#37; confidence intervals &#40;CI&#41; of HR&#46; All statistical analyses were performed using R Statistical Software &#40;version 3&#46;5&#46;3&#59; R Foundation for Statistical Computing&#44; Vienna&#44; Austria&#41;&#46; All tests were two-tailed&#44; and a <span class="elsevierStyleItalic">P</span>-value &#60;&#46;05 was considered indicative of a statistically significant association&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Results</span><p id="par0100" class="elsevierStylePara elsevierViewall">Our study cohort included a total of 162 &#40;31&#37;&#41; patients in the induced AS group and 354 &#40;69&#37;&#41; in the per-protocol AS group&#46; Supplementary material Table S1&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">After exclusions we finally analysed 304 patients on AS protocol&#46; Median follow-up from diagnosis until last RP was 45&#46;7 months &#40;IQR&#58; 26&#46;5&#8211;70&#46;3&#41;&#46; Median time to confirmatory biopsy was 7&#46;1 months &#40;IQR&#58; 6&#46;3&#8211;8&#46;8&#41;&#46; <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">142 patients &#40;27&#37; out of 516 patients on AS&#41; received active treatment &#40;focal therapy&#44; n&#160;&#61;&#160;8&#59; brachytherapy&#44; n&#160;&#61;&#160;16&#59; radiotherapy&#44; n&#160;&#61;&#160;10&#59; combination of both brachytherapy and radiotherapy&#44; n&#160;&#61;&#160;5&#59; cryotherapy&#44; n&#160;&#61;&#160;2&#59; androgen deprivation therapy &#40;ADT&#41;&#44; n&#160;&#61;&#160;1&#59; RP&#44; n&#160;&#61;&#160;100&#41; whilst 162 patients remained on AS &#40;153&#44; 29&#37; out of 516&#41; or were converted to watchful-waiting &#40;9&#44; 2&#37; out of 516&#41;&#46; Supplementary material Table S2&#46;</p><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Radical prostatectomy following AS protocol descriptive</span><p id="par0115" class="elsevierStylePara elsevierViewall">A total of 100 patients underwent RP&#44; 31 &#40;31&#37;&#41; in the &#8220;induced&#8221; and 69 &#40;69&#37;&#41; in &#8220;per-protocol&#8221; AS group&#46; RP was performed due to reclassification in 66 &#40;66&#37;&#41;&#44; progression in 18 &#40;18&#37;&#41; and anxiety in 16 &#40;16&#37;&#41; patients&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">The baseline clinical features on the RP group at PCa diagnosis and following surgery are shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> and Supplementary material Table S3&#46; At diagnosis median age was 64&#46;6 years &#40;IQR&#58; 59&#46;5&#8722;68&#41; and median PSA was 5&#46;2&#160;ng&#47;mL &#40;IQR&#58; 3&#46;8&#8722;6&#46;5&#41;&#46; Median follow-up after RP was 31&#46;4 months &#40;16&#8722;54&#41;&#46; <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> and Supplementary material Table S3&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0125" class="elsevierStylePara elsevierViewall">RP specimen&#8217;s GS was 3&#160;&#43;&#160;3 in 32 patients &#40;32&#37;&#41;&#44; 3&#160;&#43;&#160;4 in 45 &#40;45&#37;&#41;&#44; 4&#160;&#43;&#160;3 in 21 &#40;21&#37;&#41;&#44; 4&#160;&#43;&#160;5 in 1 &#40;1&#37;&#41; and 5&#160;&#43;&#160;4 in 1 patient &#40;1&#37;&#41;&#46; 23&#37; of patients had positive surgical margins &#40;PSM&#41;&#46; Positive lymph nodes &#40;N1&#41; were noticed in 5 patients &#40;5&#37;&#41;&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">pT3 ratio was higher among &#8220;induced&#8221; AS &#40;9 patients out of 31&#44; 29&#37; vs &#8220;per-protocol&#8221;&#58; 16 patients out of 69&#44; 23&#37;&#41;&#46; Median tumor volume was 1&#46;7&#160;mL &#40;IQR&#58; 1&#46;1&#8722;3&#46;3&#41; in &#8220;induced&#8221; AS&#44; compared to 1&#46;3&#160;mL &#40;IQR&#58; 0&#46;6&#8722;2&#46;3&#41; in the &#8220;per-protocol&#8221; cohort &#40;<span class="elsevierStyleItalic">P</span>&#160;&#61;&#160;&#46;09&#41;&#46; 2 patients &#40;out of 31&#44; 6&#37;&#41; with Gleason Score 9 were reported in the &#8220;induced&#8221; AS group&#46; PSM were more frequent among &#8220;induced&#8221; AS group &#40;32&#37; compared to 19&#37; of &#8220;per-protocol&#8221; patients&#41;&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">When stratified based on indication for RP &#40;reclassification&#44; progression or anxiety&#41;&#44; PSA pre-RP was significantly higher in the progression group with a median of 8&#46;2&#160;ng&#47;mL&#44; &#40;IQR&#58; 6&#46;9&#8722;12&#44; <span class="elsevierStyleItalic">P</span>&#160;&#61;&#160;&#46;002&#41;&#46; Rate of positive lymph nodes &#40;N1&#41; was significantly higher in the progression group &#40;11&#37; compared to 5&#37; in reclassification and 0&#37; in anxiety group&#44; <span class="elsevierStyleItalic">P</span>&#160;&#61;&#160;&#46;002&#41;&#46; A slightly higher proportion of pT3 disease was observed in the progression group &#40;28&#37; vs 26&#37; of the reclassification group&#41;&#44; however was not significantly different&#46; 6&#37; of the progression cohort had a Gleason Score of 9 on prostatectomy specimen compared to 1&#37; in the reclassification cohort&#46; Finally&#44; PSM were more frequently reported in the progression subgroup compared to reclassification &#40;28&#37; vs 20&#37;&#41;&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Insignificant PCa at RP specimen was observed in 7 patients &#40;7&#37;&#41; according to Epstein criteria &#40;3 patients &#40;5&#37;&#41; from the reclassification group and 4 patients &#40;25&#37;&#41; from the anxiety group&#41;&#46; When applying Wolters definition&#44; 24 &#40;24&#37;&#41; patients had insignificant PCa &#40;15 patients &#40;23&#37;&#41; from the reclassification group&#59; 3 patients &#40;17&#37;&#41; from the progression group and 6 patients &#40;37&#37;&#41; from the anxiety group&#41;&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Adverse pathological features rate was 36&#37;&#44; no statistically significant differences were observed between AS groups &#40;&#8220;induced&#8221;&#44; n&#160;&#61;&#160;13 &#40;42&#37;&#41; vs &#8220;per-protocol&#8221;&#44; n&#160;&#61;&#160;23 &#40;33&#37;&#41;&#44; <span class="elsevierStyleItalic">P</span>&#160;&#61;&#160;&#46;546&#41; or indications for RP &#40;reclassification&#44; n&#160;&#61;&#160;25 &#40;38&#37;&#41; vs progression&#44; n&#160;&#61;&#160;8 &#40;44&#37;&#41; vs anxiety&#44; n&#160;&#61;&#160;3 &#40;19&#37;&#41;&#44; <span class="elsevierStyleItalic">P</span>&#160;&#61;&#160;&#46;256&#41;&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Biochemical recurrence free survival outcomes</span><p id="par0150" class="elsevierStylePara elsevierViewall">Median follow-up from diagnosis until last RP was 48&#46;3 months &#40;IQR&#58; 32&#46;4&#8722;70&#41;&#46; 3 year-biochemical recurrence free survival &#40;BRFS&#41; post RP was 85&#46;4&#37; &#40;95&#37; CI&#58; 78&#46;3&#8211;93&#46;1&#41;&#46; There were no significant differences in BRFS between AS groups &#40;<span class="elsevierStyleItalic">P</span>&#160;&#61;&#160;&#46;5&#41; or amongst indications for RP &#40;<span class="elsevierStyleItalic">P</span>&#160;&#61;&#160;&#46;62&#41;&#46; <a class="elsevierStyleCrossRefs" href="#fig0005">Figs&#46; 1&#8211;3</a>&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Discussion</span><p id="par0155" class="elsevierStylePara elsevierViewall">Despite PCa AS being supported by major society guidelines&#44; there is still hesitation surrounding its uptake&#46;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#44;11</span></a> The rational for it relies on several reasons such as heterogeneity among AS protocols selection criteria&#44; timing of follow-up and indications for active treatment&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> Consequently&#44; there is an increased need to reach a consensus for AS strategies&#46;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">13&#44;14</span></a> Of note&#44; patient selection and further management while on AS would be implemented in the near future by optimizing mpMRI and use of biomarkers &#40;e&#46;g&#46; Prostate Health Index&#44; PHI&#59; Prostate Cancer Antigen 3&#44; PCA3&#41;&#44; encouraging a personalized precision medicine&#46;<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">15&#8211;17</span></a></p><p id="par0160" class="elsevierStylePara elsevierViewall">In the current study&#44; 516 patients were included in our AS cohort&#44; RP was performed during follow-up in 100 patients &#40;19&#37;&#41;&#46; In line with previous similar publication reporting outcomes of RP within AS protocols&#44;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">18&#8211;21</span></a> a third of the patients included in AS protocol do not fulfil strict inclusion criteria&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">In patients who underwent RP after &#8220;induced&#8221; AS&#44; pathological characteristics of surgical specimen as well as biochemical outcomes during follow-up were slightly worse&#46; These findings suggest that we should be cautious in broadening the inclusion criteria&#46; Additionally&#44; patients outside of the criteria who wish to be managed with AS should be informed of the potential for increased risk of progression on AS&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">The most frequent reason to perform RP after AS was reclassification &#40;66&#37;&#41;&#46; RP was performed due to patient anxiety in 16 cases &#40;16&#37;&#41; in our population&#44; lower compared to Hong et al&#46; analysis<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a> and the last update from the PRIAS study&#44;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a> which were 25&#46;3&#37; and 29&#37; respectively&#59; but higher than Bul et al&#46; report &#40;12&#46;7&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a></p><p id="par0175" class="elsevierStylePara elsevierViewall">Median follow-up after RP was 31&#46;4 months &#40;16&#8722;54&#41;&#44; shorter than other series&#46;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">20&#44;21</span></a> Biochemical relapse was experienced by 15&#37; of the RP cohort&#44; without significant differences between groups&#46; This is comparable with the G&#246;teborg group who reported a PSA relapse in 19&#37; of their cohort&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a> In contrast&#44; the Memorial Sloan Kettering Cancer Center group reported recurrence in only 1 patient &#40;1&#46;5&#37;&#41;&#44; however&#44; they did not include patients reclassified on confirmatory biopsy&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">In their long term follow-up study&#44; Klotz et al&#46; reported a biochemical-relapse free survival rate after RP at 5&#44; 10 and 15 years of 80&#37;&#44; 65&#37; and 54&#37; respectively&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a> Similarly&#44; in our cohort&#44; we estimate that the biochemical relapse-free survival after RP at 5 years will be 83&#46;6&#37; &#40;95&#37; CI&#58; 76&#37;&#8211;92&#37;&#41;&#46; However&#44; a longer follow-up is required to compare results between Klotz and our cohort&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">One of the principal objectives of AS is to avoid overtreatment&#46; However&#44; patients on AS who subsequently undergo radical therapy may still be overtreated&#46; Several groups have reported potentially insignificant PCa found in RP specimens after AS&#46; Duffield et al&#46; found that 27&#37; of tumors were organ confined&#44; dominant nodule &#60;0&#46;5&#160;cm<span class="elsevierStyleSup">3</span> with no Gleason pattern 4 or 5&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> In their prospective observational study&#44; Bul et al&#46; reported that 28&#37; had no Gleason pattern 4 or 5 and no extracapsular extension&#44; however no tumor volume was specified&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> Hong et al&#46; observed 30&#46;4&#37; patients with organ confined disease and no Gleason pattern 4 or 5&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a></p><p id="par0190" class="elsevierStylePara elsevierViewall">The Epstein criteria for insignificant PCa have been globally accepted since first published in 1993&#46;<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">24&#44;25</span></a> However&#44; in 2011&#44; Wolters et al&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> published less strict criteria&#46; More recently&#44; Kryvenko and Epstein<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> discussed in their study the definitions of insignificant tumor volume in GS 6&#44; concluding that an increase in volume above 0&#46;5&#160;cm<span class="elsevierStyleSup">3</span> was associated in their cohort with a significant increase in likelihood of extra-prostatic extension and positive surgical margins&#46; When using Epstein&#180;s criteria&#44; we found an insignificant PCa ratio of 7&#37;&#44; whereas for Wolters&#180; definition&#44; the ratio was higher at 24&#37;&#46; In our cohort&#44; for both definitions&#44; this ratio was higher among the anxiety group&#44; in whom RP was performed exclusively based on patient wishes&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">36 patients in our cohort &#40;36&#37;&#41; demonstrated adverse pathological features on RP specimen histology&#44; the highest proportion being among the progression cohort &#40;not statistically significant&#41;&#46; Positive lymph node rates were significantly greater for disease progression RP compared with reclassification and anxiety&#46; We were unable to find significant differences between &#8220;induced&#8221; vs &#8220;per-protocol&#8221; AS&#44; however the ratio of adverse pathological features was higher among the induced AS cohort &#40;42&#37; vs 33&#37;&#41;&#46; In comparison&#44; Bul et al&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> reported unfavorable RP results &#40;pT3-4 and&#47;or GS&#160;&#8805;&#160;4&#160;&#43;&#160;3&#41; in 29&#37; of cases&#46; Whilst our population had a slightly higher proportion of patients with adverse features on histopathology&#44; this may be contributed by the inclusion of patients not fulfilling the inclusion criteria&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">The present study has several limitations&#46; Firstly&#44; it is a retrospective study of a single institution&#180;s experience&#46; Furthermore&#44; whilst our numbers are comparable to previous studies assessing RP following AS&#44;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">18&#8211;21</span></a> potentially our cohort was too small and lacked the power to identify clinical or pathological factors at diagnosis significantly associated with the presence of insignificant PCa or adverse pathological features&#46; Median follow-up was less than 5 years compared to other series&#46; Finally&#44; in all AS series patient anxiety&#44; as a subjective component&#44; makes comparison of outcomes difficult due to lack of standardization&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Conclusion</span><p id="par0205" class="elsevierStylePara elsevierViewall">The small number of patients who undergo RP following AS for insignificant PCa suggests that AS limits overtreatment of low-risk PCa&#46; Furthermore&#44; two-thirds of our patients do not demonstrate adverse pathological features suggesting RP can be considered a safe treatment strategy after failing AS&#46; Future studies should aim to further clarify selection criteria for AS whilst attempting to achieve a consensus among protocols in order to globalize the uptake of AS strategy as a management option in selected PCa patients&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Funding</span><p id="par0210" class="elsevierStylePara elsevierViewall">This research has not received specific funding from public sector agencies&#44; commercial sector or non-profit entities&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Conflicts of interests</span><p id="par0215" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interests&#46;</p></span></span>"
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          "identificador" => "xres1519035"
          "titulo" => "Abstract"
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          "titulo" => "Resumen"
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              "titulo" => "Material y m&#233;todos"
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          "titulo" => "Introduction"
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          "titulo" => "Methods"
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            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Inclusion criteria definition for AS cohort"
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            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "AS protocol within our institution"
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              "titulo" => "Endpoints of study"
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          "titulo" => "Results"
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              "identificador" => "sec0040"
              "titulo" => "Radical prostatectomy following AS protocol descriptive"
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              "identificador" => "sec0045"
              "titulo" => "Biochemical recurrence free survival outcomes"
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          "titulo" => "Discussion"
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          "titulo" => "Funding"
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    "fechaRecibido" => "2020-06-15"
    "fechaAceptado" => "2020-09-14"
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          "clase" => "keyword"
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            0 => "Active surveillance"
            1 => "Disease progression"
            2 => "Prostate"
            3 => "Prostatectomy"
            4 => "Prostatic neoplasms"
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          "clase" => "keyword"
          "titulo" => "Palabras clave"
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          "palabras" => array:5 [
            0 => "Vigilancia activa"
            1 => "Progresi&#243;n de la enfermedad"
            2 => "Pr&#243;stata"
            3 => "Prostatectom&#237;a"
            4 => "Neoplasias prost&#225;ticas"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Determine whether our institution&#180;s active surveillance &#40;AS&#41; protocol is a suitable strategy to minimise prostate cancer overtreatment&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material and Methods</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Retrospective analysis of 516 patients on AS after prostate cancer diagnosis&#46; Population divided into &#8220;per-protocol&#8221; vs &#8220;induced&#8221; AS depending on fulfilment of protocol&#180;s inclusion criteria&#46; Radical prostatectomies after AS were selected and stratified based on&#58; reclassification&#44; progression or patient anxiety&#46; Clinicopathological features and biochemical relapse-free survival were studied&#46; Primary endpoint was overtreatment ratio based on the presence of insignificant prostate cancer and adverse pathological features in the surgical specimen&#46; Kaplan-Meier curves were used to estimate the biochemical relapse-free survival and compared with log-rank test&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">304 patients fulfilled inclusion criteria&#59; 100 proceeded to radical prostatectomy &#40;31&#37; &#8220;induced&#8221;&#44; 69&#37; &#8220;per-protocol&#8221; AS&#41;&#46; Surgery indications were reclassification&#44; progression and anxiety in 66&#37;&#44; 18&#37; and 16&#37; of patients respectively&#46; Rate of positive lymph nodes was higher in the progression group &#40;11&#37;&#41; compared to reclassification and anxiety &#40;5&#37; and 0&#37; respectively&#44; <span class="elsevierStyleItalic">P</span>&#160;&#61;&#160;&#46;002&#41;&#46; Positive surgical margins were more frequently reported in the progression cohort compared to reclassification &#40;28&#37; vs 20&#37;&#41;&#46; Median follow-up from diagnosis until last radical prostatectomy was 48&#46;3 months &#40;32&#46;4&#8722;70&#41;&#46; 3 year biochemical relapse-free survival in the salvage radical prostatectomy was 85&#46;4&#37; &#40;95 CI 78&#46;3&#8211;93&#46;2&#41;&#46; Insignificant cancer was noticed in 7&#37; of patients &#40;Epstein&#180;s vs 24&#37; Wolters&#180; criteria&#41;&#46; Rate of patients with adverse pathological features was 36&#37;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">The majority of patients who underwent salvage surgery after AS were not overtreated&#46; Radical prostatectomy should be considered a safe rescue treatment&#46;</p></span>"
        "secciones" => array:4 [
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          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Material and Methods"
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          2 => array:2 [
            "identificador" => "abst0015"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">Determinar si el protocolo de vigilancia activa &#40;VA&#41; de nuestra instituci&#243;n es una estrategia adecuada para minimizar el sobretratamiento del c&#225;ncer de pr&#243;stata&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y m&#233;todos</span><p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">An&#225;lisis retrospectivo de 516 pacientes en VA tras el diagn&#243;stico de c&#225;ncer de pr&#243;stata&#46; La poblaci&#243;n se dividi&#243; en VA &#8220;por protocolo&#8221; vs&#46; &#8220;inducida&#8221; dependiendo del cumplimiento de los criterios de inclusi&#243;n del protocolo&#46; Las prostatectom&#237;as radicales despu&#233;s de la VA fueron seleccionadas y estratificadas en base a&#58; reclasificaci&#243;n&#44; progresi&#243;n o ansiedad del paciente&#46; Se estudiaron las caracter&#237;sticas cl&#237;nico-patol&#243;gicas y la supervivencia libre de recidiva bioqu&#237;mica&#46; La variable principal del estudio fue el porcentaje de sobretratamiento con relaci&#243;n a la presencia de un c&#225;ncer de pr&#243;stata insignificante y de caracter&#237;sticas patol&#243;gicas adversas en la pieza quir&#250;rgica&#46; Se utilizaron las curvas de Kaplan-Meier para estimar la supervivencia libre de recidiva bioqu&#237;mica y se compararon con la prueba log-rank&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">304 pacientes cumplieron los criterios de inclusi&#243;n&#59; 100 procedieron a una prostatectom&#237;a radical &#40;31&#37; &#8220;VA inducida&#8221;&#44; 69&#37; &#8220;VA por protocolo&#8221; VA&#41;&#46; Las indicaciones para la cirug&#237;a fueron el reclasificaci&#243;n&#44; la progresi&#243;n y la ansiedad de los pacientes &#40;66&#37;&#44; 18&#37; y 16&#37;&#44; respectivamente&#41;&#46; La tasa de ganglios linf&#225;ticos positivos fue mayor en el grupo de progresi&#243;n &#40;11&#37;&#41; en comparaci&#243;n con la reclasificaci&#243;n y la ansiedad &#40;5&#37; y 0&#37; respectivamente&#44; <span class="elsevierStyleItalic">P</span>&#160;&#61;&#160;&#44;002&#41;&#46; Los m&#225;rgenes quir&#250;rgicos positivos fueron m&#225;s frecuentes en la cohorte de progresi&#243;n en comparaci&#243;n con la reclasificaci&#243;n &#40;28&#37; vs&#46; 20&#37;&#41;&#46; La media de seguimiento desde el diagn&#243;stico hasta la &#250;ltima prostatectom&#237;a radical fue de 48&#44;3 meses &#40;32&#44;4&#8211;70&#41;&#46; La supervivencia libre de recidiva bioqu&#237;mica a los 3 a&#241;os en la prostatectom&#237;a radical de rescate fue del 85&#44;4&#37; &#40;95 CI 78&#44;3&#8211;93&#44;2&#41;&#46; Se observ&#243; un c&#225;ncer insignificante en el 7&#37; de los pacientes &#40;criterio de Epstein vs&#46; 24&#37; de Wolters&#41;&#46; La tasa de pacientes con caracter&#237;sticas patol&#243;gicas adversas fue del 36&#37;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">La mayor&#237;a de los pacientes que se sometieron a cirug&#237;a de rescate despu&#233;s de la VA no recibieron sobretratamiento&#46; La prostatectom&#237;a radical deber&#237;a ser considerada un tratamiento de rescate seguro&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Polo Alonso E&#44; Ram&#237;rez-Backhaus M&#44; Wei G&#44; Mascar&#243;s JM&#44; Arag&#243;n Rodriguez F&#44; G&#243;mez-Ferrer &#193;&#44; et al&#46; &#191;La vigilancia activa evita el sobretratamiento en el c&#225;ncer de pr&#243;stata&#63; Lecciones aprendidas de prostatectom&#237;as radicales de rescate&#46; Actas Urol Esp&#46; 2021&#59;45&#58;373&#8211;382&#46;</p>"
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            "apendice" => "<p id="par0225" class="elsevierStylePara elsevierViewall">The following is Supplementary data to this article&#58;<elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>"
            "etiqueta" => "Appendix A"
            "titulo" => "Supplementary data"
            "identificador" => "sec0075"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Biochemical recurrence-free survival rates of patients undergoing RP after AS&#46; After a median follow-up of 48&#46;3 months &#40;IQR&#58; 32&#46;4&#8211;70&#41; from diagnosis until last RP&#44; the 3 year-BRFS post RP was 85&#46;4&#37; &#40;95&#37; CI&#58; 78&#46;3&#8211;93&#46;1&#41;&#46;</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">RP&#44; radical prostatectomy&#59; IQR&#44; interquartile range&#59; BRFS&#44; biochemical recurrence free survival&#46;</p>"
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          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Kaplan-Meier Curves depicting the Biochemical Recurrence-Free survival over time stratified among &#8220;induced AS&#8221; and &#8220;per-protocol AS&#8221; groups&#46; The 3 year-BRFS post RP was 82&#46;9&#37; &#40;95&#37; CI&#58; 70&#46;3&#8211;97&#46;8&#41; in &#8220;induced AS&#8221; group and 86&#46;6&#37; &#40;95&#37; CI&#58; 78&#46;3&#8211;95&#46;8&#41; in &#8220;per-protocol AS&#8221; group&#46; No significant differences in BRFS between AS groups &#40;<span class="elsevierStyleItalic">P</span>&#160;&#61;&#160;&#46;5&#41;&#46;</p> <p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">AS&#44; active surveillance&#59; BRFS&#44; biochemical recurrence free survival&#59; RP&#44; radical prostatectomy&#59; CI&#44; confidence interval&#46;</p>"
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          "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Kaplan-Meier Curves depicting the Biochemical Recurrence-Free survival over time stratified among indications for RP after AS &#40;reclassification and progression&#41;&#46; The 3 year-BRFS post RP was 87&#46;1&#37; &#40;95&#37; CI&#58; 78&#46;3&#8211;96&#46;7&#41; in &#8220;reclassification&#8221; group and 83&#46;3&#37; &#40;95&#37; CI&#58; 67&#46;8&#8211;100&#41; in &#8220;progression&#8221; group&#46; No significant differences in BRFS amongst indications for RP &#40;<span class="elsevierStyleItalic">P</span>&#160;&#61;&#160;&#46;62&#41;&#46;</p> <p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">AS&#44; active surveillance&#59; BRFS&#44; biochemical recurrence free survival&#59; RP&#44; radical prostatectomy&#59; CI&#44; confidence interval&#46;</p>"
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          "leyenda" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Bolded</span> values indicate statistical significance &#40;<span class="elsevierStyleItalic">P</span>&#160;&#60;&#160;&#46;05&#41;&#46;</p><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">BMI&#44; body mass index&#59; ASA&#44; American Society of Anesthesiologists&#59; IQR&#44; interquartile range&#59; GS&#44; Gleason score&#59; AS&#44; active surveillance&#46;</p>"
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27 &#40;24&#46;6&#8722;29&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#46;243&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#46;363&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t">&#46;650&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                      "titulo" => "Active surveillance for low-risk prostate cancer&#8239;&#58; The European Association of Urology Position in 2018"
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                    0 => array:2 [
                      "titulo" => "Radical prostatectomy findings in patients in whom active surveillance of prostate cancer fails"
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