The study was done to identify and validate clinical parameters that can identify men who can safely defer follow-up prostate cancer assessments.
850 men were included in the PASS cohort. 533 men were included in the UCSF cohort. Parameters predictive of reclassification on the multivariable analysis included maximum percent positive cores, history of any negative biopsy after diagnosis, time since diagnosis, body mass index, prostate size, prostate-specific antigen at diagnosis, and prostate-specific antigen kinetics. For the prediction of non-reclassification at 4 years, the area under the receiver operating curve was 0.70 for the PASS cohort and 0.70 for the UCSF validation cohort. This model achieved a negative predictive value of 0.88 for those in the bottom 25th percentile of risk and of 0.95 for those in the bottom 10th percentile.
The study concluded that among men with low-risk prostate cancer, heterogeneity prevailed in the risk of subsequent disease reclassification. These findings suggest that active surveillance intensity can be modulated based on an individual’s risk parameters and that many men may be safely monitored with a substantially less intensive surveillance regimen.