Do active surveillance patients in Victoria, Australia, meet the criteria for PRIAS?

Introduction: Active Surveillance (AS) is increasingly used in the management of men with low -risk prostate cancer. With the increased uptake of AS, several protocols are in place to manage such patients. Of these, PRIAS is currently the largest recruiting. The aim of this study was to look at the uptake and utilization of AS in this cohort of men according to contemporary AS protocols (PRIAS). Materials and Methods: De-identified data was obtained for 6221 men from the prostate cancer registry. Men included in this study were diagnosed with prostate cancer from 2009 to August 2012 with a minimum of 12-month follow-up. Data was acquired to describe the current utilization of AS in Victorian men, according to the PRIAS (AS) protocol. Results: The PRIAS criteria was analysed with the data sets from the registry. A total of 644 patients would have met the criteria for PRIAS to commence AS. Of these, 179/644 (27.8%) of patients were actually on AS with the remaining 465/644 (72.2)% of patients being treated with other modalities. Interestingly 627/912 (68.7%) of patients currently on AS were not eligible for PRIAS. As per treatment categories, 282/2467 (11.43%) patients undergoing radical prostatectomy met PRIAS for AS. This was also the case for 55/1163 (4.73%) of patients undergoing EBRT, 14/359 (3.75%) of patients undergoing EBRT and surgery, 60/321 (18.7%) of patients undergoing LDR, 2/337 (0.59%) in the ADT group and 7/48 (14.58%) of BT patients (P = 0.000). Conclusion: Our study suggests that despite the increased uptake of AS in a cohort of Victorian men, AS is snot used in many men who would appear suitable by PRIAS criteria with majority (72%) of patients with low risk disease being actively treated with other modalities despite fulfilling the PRIAS criteria for AS. We acknowledge that the increasing trends in utilisation of AS in recent years may influence our results, and that ongoing follow up will be required.