Comparative analysis of histological and remote oncological outcomes after radical prostatectomy in patients matching Johns Hopkins and the Royal Marsden Hospital criteria for active monitoring
A retrospective comparative analysis of results of treatment of patients with prostate cancer who met the most stringent (Johns Hopkins - JH; 74 patients) and the most mild (Royal Marsden Hospital - RMH; 263 patients) selection criteria for the management according to the strategy of active monitoring was performed. Significant differences in the frequency of detection of adverse histological features and biochemical recurrence-free survival after radical prostatectomy in patients eligible for JH and RMH criteria were not identified. Extracapsular extension occurred in 2.7 and 4.9% (P=0,33), seminal vesicle invasion - in 1.4 and 2,6% (P=0.43), positive surgical margins - in 6, 8 and 7.2 % (P=0.56), Gleason score increase - at 6.8 and 9.1 % (P=0.49), respectively. Five-year disease-free survival rates were 95.7 and 95,8% (P=0.41). Regardless of the protocol selection for active monitoring, precise examination of patients and staging of the disease are absolutely necessary, as well as the future well-designed studies on the comparative analysis of the effectiveness of active monitoring and early curative treatment in the settings of national health care.