Multicenter analysis of pathological outcomes of patients eligible for active surveillance according to prias criteria

AIM: To retrospectively analyze the pathological outcomes of patients meeting the Prostate Cancer Research International Active Surveillance (PRIAS) criteria who had undergone radical prostatectomy (RP). PATIENTS AND METHODS: Out of 2014 patients recruited for minimally invasive RP between 2008 and 2014 in 7 centers, 226 (11.2%) met the modified PRIAS criteria (clinical stage T1c/T2, PSA <10 ng/ml, 1--2 positive biopsy cores and Gleason score < 6). RESULTS: At pathological evaluation, Gleason score upgrade was reported in 47.3% of patients; 74 (32.7%), 10 (4.4%), 9 (3.9%) patients showed RP Gleason sum 7, 8 and 9, respectively. Upstaging was reported in 135 patients (59.7%). 12 (5.3%) and 4 (1.7 %) patients had T3a and T3b pathological stage respectively. CONCLUSIONS: Notwithstanding the PRIAS criteria can identify some PCa patients as low--risk, at pathological evaluation some of them harbored intermediate-- or high--risk disease. According to our data, patients eligible for AS should be carefully counseled about possible disease understaging.