Outcomes and progression predictors in a New Zealand active surveillance programme for prostate cancer

Active surveillance is a safe option for low-risk prostate cancer, our data are consistent with outcomes consistent with the Prostate Cancer Outcomes Registry and international data. PSA density and multiparametric MRI were the strongest predictors of progression; tumour volume by percentage of positive cores was not independently predictive. New draft Prostate Cancer Foundation of Australia guidelines recommend against biopsy in men with PSA density <0.15 ng/mL/cc and no PIRADS 3-5 lesion on MRI[7], in our cohort this included many men with ISUP 1 cancer. They had a 17.2% progression rate to ISUP ≥2, and their clinically significant disease might have been missed without close surveillance.