A Comparison of Periodic Rebiopsy versus Patient-Based Rebiopsy in Prostate Cancer Active Surveillance.

IntroductionIn low-risk prostate cancer (PCa), the aim of active surveillance (AS) is to reduce overtreatment and avoid potential adverse effects. The rebiopsy approach in AS remains debated, spanning routine scheduled biopsies to clinically- or imaging-driven rebiopsies based on PSA kinetics or multiparametric MRI (mpMRI). In this retrospective, single-center comparative cohort study, we examined outcomes of periodic vs patient-based rebiopsy during AS and evaluated oncological outcomes in patients with PCa.MethodsSeventy-four patients who underwent at least one year of AS for PCa between January 2019 and July 2024 were retrospectively analyzed. Two distinct AS protocol patients were included in the study from 4 different physicians in our clinic. Demographic data, PSA levels, PSA kinetics, mpMRI findings, and rebiopsy pathology results were documented. Radical prostatectomy (RP) pathology results and factors influencing definitive treatment (DT) decisions were compared between the 2 groups: periodic rebiopsy (n = 41), and patient-based rebiopsy (n = 33).ResultsThe median rebiopsy time was shorter in the periodic group (12.5 months, IQR: 1) than in the patient-based group (14 months, IQR: 9;