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</o:shapelayout></xml><![endif]--></head><body lang=EN-CA link=blue vlink=purple><div class=WordSection1><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>Hi all:<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>Interesting article based on a Canadian study.<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>Take care,<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>Glen<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><o:p> </o:p></p><div><h2><a href="http://www.urotoday.com/2014-09-18-02-47-34/prostate-cancer/83971-an-increase-in-gleason-6-tumour-volume-while-on-active-surveillance-portends-a-greater-risk-of-grade-re-classification-with-further-follow-up.html">An increase in Gleason 6 tumour volume while on active surveillance portends a greater risk of grade re-classification with further follow-up.</a> <o:p></o:p></h2><ul type=disc><li class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;mso-list:l0 level1 lfo1'><o:p> </o:p></li></ul><p class=MsoNormal style='margin-left:36.0pt'>Published: 12 October 2015 <o:p></o:p></p><p class=MsoNormal><o:p> </o:p></p><p>We evaluated the relative risk of later grade re-classification and outcomes of patients who developed high-volume Gleason 6 prostate cancer (PCa) while on active surveillance (AS).<o:p></o:p></p><p>A prospectively maintained database was used to identify patients on AS between 1998 and 2013.<o:p></o:p></p><p><o:p> </o:p></p><p>Tumour volume was assessed based on number of positive cores and proportion of core involvement. Chi-square and Fisher's exact test were used for analysis where appropriate. The primary endpoint was development of grade re-classification, defined as grade only and/or grade and volume at the event biopsy.<o:p></o:p></p><p><o:p> </o:p></p><p>A total of 555 men met study inclusion criteria. Mean follow-up was 46 months. Overall, 70 patients demonstrated an increase in tumour volume at or after their second biopsy (B2). In comparison to those never experiencing volume or grade re-classification, prostate-specific antigen at diagnosis was not significantly different (p=0. 95), but median prostate volume was smaller in patients who demonstrated volume re-classification (p<o:p></o:p></p><p>While Gleason 6 PCa has a favourable natural history, it appears that AS patients who experience volume re-classification are at a substantially higher risk of developing grade re-classification. Thus, urologists should pay close attention to tumour core involvement and monitoring should be adjusted accordingly for early volume re-classification in younger men and in good health.<o:p></o:p></p><p><o:p> </o:p></p><p>The Journal of urology. 2015 Sep 25 [Epub ahead of print]<o:p></o:p></p><p>Maria Komisarenko, Lih-Ming Wong, Patrick O Richard, Narhari Timilshina, Ants Toi, Andrew Evans, Alexandre Zlotta, Girish Kulkarni, Robert Hamilton, Neil Fleshner, Antonio Finelli<o:p></o:p></p><p>Department of Uro-oncology, Division of Surgical Oncology, Princess Margaret Cancer Center, University Health Network, Toronto, Canada. , Department of Urology, St Vincent's Hospital, Melbourne, Australia, Toronto, Canada. , Department of Uro-oncology, Division of Surgical Oncology, Princess Margaret Cancer Center, University Health Network, Toronto, Canada. , Department of Uro-oncology, Division of Surgical Oncology, Princess Margaret Cancer Center, University Health Network, Toronto, Canada. , Department of Uro-oncology, Division of Surgical Oncology, Princess Margaret Cancer Center, University Health Network, Toronto, Canada. , Department of Pathology, Toronto General Hospital, University of Toronto, Canada, Toronto, Canada. , Department of Uro-oncology, Division of Surgical Oncology, Princess Margaret Cancer Center, University Health Network, Toronto, Canada. , Department of Uro-oncology, Division of Surgical Oncology, Princess Margaret Cancer Center, University Health Network, Toronto, Canada. , Department of Uro-oncology, Division of Surgical Oncology, Princess Margaret Cancer Center, University Health Network, Toronto, Canada. , Department of Uro-oncology, Division of Surgical Oncology, Princess Margaret Cancer Center, University Health Network, Toronto, Canada. , Department of Uro-oncology, Division of Surgical Oncology, Princess Margaret Cancer Center, University Health Network, Toronto, Canada. <o:p></o:p></p><p><o:p> </o:p></p><p><o:p> </o:p></p><p><o:p> </o:p></p><p><o:p> </o:p></p><p><a href="url:http://www.urotoday.com/index.php?option=com_content&view=article&id=83971:an-increase-in-gleason-6-tumour-volume-while-on-active-surveillance-portends-a-greater-risk-of-grade-re-classification-with-further-follow-up&catid=1134:prostate-cancer&Itemid=782&utm_source=newsletter_3049&utm_medium=email&utm_campaign=uroalerts-prostate-cancer-weekly">url:http://www.urotoday.com/index.php?option=com_content&view=article&id=83971:an-increase-in-gleason-6-tumour-volume-while-on-active-surveillance-portends-a-greater-risk-of-grade-re-classification-with-further-follow-up&catid=1134:prostate-cancer&Itemid=782&utm_source=newsletter_3049&utm_medium=email&utm_campaign=uroalerts-prostate-cancer-weekly</a><o:p></o:p></p></div><p class=MsoNormal>-- <br>You received this message because you are subscribed to the Google Groups "FYI Prostate Info" group.<br>To unsubscribe from this group and stop receiving emails from it, send an email to <a href="mailto:fyi-prostate-info+unsubscribe@googlegroups.com">fyi-prostate-info+unsubscribe@googlegroups.com</a>.<br>To post to this group, send email to <a href="mailto:fyi-prostate-info@googlegroups.com">fyi-prostate-info@googlegroups.com</a>.<br>To view this discussion on the web visit <a href="https://groups.google.com/d/msgid/fyi-prostate-info/d4517eef-a8c6-4864-984c-1368dc4cf163%40googlegroups.com?utm_medium=email&utm_source=footer">https://groups.google.com/d/msgid/fyi-prostate-info/d4517eef-a8c6-4864-984c-1368dc4cf163%40googlegroups.com</a>.<br>For more options, visit <a href="https://groups.google.com/d/optout">https://groups.google.com/d/optout</a>.<o:p></o:p></p></div></body></html>