primary treatment for PCa between September 2001 and December 2013 at a high volume US tertiary referral center was used. Patients satisfying Epstein’s criteria pre-operatively for AS based on a standard biopsy strategy (Biopsy Gleason 6 or less, clinical stage T1b or T1c, pre-operative PSA 10ng/ml or less, tumor volume in any core less than 50% and only 1 or 2 positive cores) were identified. Race, Post-surgical disease stage, Gleason score, lymph node status, tumor volume assessment and biochemical recurrence free survival (BRFS) were assessed. Statistical differences in post-operative dis- ease status were assessed with Chi square or Fisher Exact test (categorical variables) and t-distribution for Pearson correlation coefficient. RESULTS: 6,372 men underwent RARP, of whom 1,358 (21.3%) satisfied Epstein’s criteria for AS. 22% Caucasians and only 14% African-Americans met AS criteria. No racial differences in post-surgical disease status or outcome were noted. 209 of patient’s satisfying Epstein’s criteria (15.3%) had pathological stage T3 or T4 disease and 2 patients had positive lymph nodes. 550 patients (41%) were upgraded on final pathology with 68 (5%) having Gleason 4+3 disease and 11 (1%) having Gleason 8 or more dis- ease. Tumor volume in the biopsy specimen significantly correlated with final pathology volume (p<0.001). Among those operated prior to 2006, 83.7% of AS candidates were found to have significant disease at final pathology whereas after 2006, only 68.4% had significant disease. Those meeting AS criteria were significantly less likely to encounter biochemical recurrence at 8 years (0.96 vs 0.73) and 10 years (0.93 vs 0.69) (Log rank test, p<0.001). There was a significant decreasing trend in patients qualifying for AS who were operated on over this 12 year period from 25.5% to 12.3% (p<0.001). CONCLUSIONS: Although a significant number of patients meeting Epstein’s criteria were found to be upstaged, upgraded and likely to have significant disease at RARP, this did not appear to affect long term outcome suggesting accuracy in patient selection for AS. Source of Funding: none PD03-11 PATHOLOGIC OUTCOMES AMONG MEN WITH EARLY VERSUS DELAYED PROGRESSION TO RADICAL PROSTATECTOMY AFTER INITIAL ACTIVE SURVEILLANCE Nima Almassi*, Yaw Nyame, Daniel Greene, Vishnu Ganesan, Charles Dai, Joseph Zabell, Samuel Haywood, Chad Reichard, Anna Zampini, Hans Arora, Alice Crane, Daniel Hettel, Ahmed El- Shafei, Robert Stein, Khaled Fareed, Michael Gong, J. Stephen Jones, Andrew Stephenson, Eric Klein, Cleveland, OH INTRODUCTION AND OBJECTIVES: In men managed with active surveillance (AS) for prostate cancer, previous literature has reported rates of unfavorable pathology near 30% in patients who progressed to radical prostatectomy (RP). Comparisons of patho- logic outcomes in patients considered for AS treated within six months of diagnosis versus men who undergo delayed treatment (>6 months) on AS are limited. The objective of this study was to compare pathologic outcomes between patients who progressed on AS to surgery within 6 months of diagnosis (early RP) to patients who progressed beyond six months after initial diagnosis (delayed RP). We also compared pathologic outcomes in patients with type I progression, defined as Gleason upstaging, patients with type II progression, defined as predominant Gleason pattern 4 or 5 or >50% of cores positive, and patients who proceed to RP without progression. METHODS: A retrospective review of an AS database of 639 prostate cancer patients managed with active surveillance at our insti- tution from 2002-2015 was performed. Unfavorable surgical pathology was defined as predominant Gleason score 4 or 5, Gleason sum 8-10, extracapsular extension, presence of seminal vesicle or lymph node invasion. Incidence of adverse pathology between groups was compared with chi-square analysis. RESULTS: A total of 104 patients progressed to surgery while on AS, for whom surgical pathologic data was available in 101. A total of 35 patients (34.7%) demonstrated adverse pathologic features. Of those who underwent surgery, 37 patients underwent early RP while 67 underwent delayed RP at a median of 299 days (IQR 114.5-665.75) after initial diagnosis. There was no difference in incidence of adverse pathology between early and delayed RP (33.3% vs34.4%; p¼1.0). Patients with type II progression who underwent RP had a 50% inci- dence adverse pathology compared to 29.2% for type I progres- sion (p¼0.15). CONCLUSIONS: There is no difference in the incidence of adverse surgical pathology between men on AS who undergo early RP versus delayed RP. Men with type II progression on AS who undergo RP may have a higher incidence of adverse pathology compared to men with type 1 progression. Source of Funding: None PD03-12 APPLYING SEVEN CONTEMPORARY ACTIVE SURVEILLANCE PROTOCOLS TO PATIENTS UNDERGOING RADICAL PROSTATECTOMY: SIGNIFICANT DIFFERENCES IN MIDTERM ONCOLOGICAL OUTCOMES Sami-Ramzi Leyh-Bannurah*, Montreal, Canada; Petra Str€ olin, Pierre Tennstedt, Thomas Steuber, Hans Heinzer, Markus Graefen, Lars Bud€ aus, Hamburg, Germany INTRODUCTION AND OBJECTIVES: Despite using similar clinical predictors, active surveillance (AS) inclusion criteria greatly differ. To compare the midterm oncological performance between AS protocols and evaluate the implications for daily clinical practice. METHODS: Patients opting for radical prostatectomy (RP) in a European tertiary care center between 2008 to 2015 were retro- spectively strati fied according to established AS criteria (clinical stage, Gleason grade[GS], PSA, total positive cores [PC], maximum single core positivity [SCP] and PSA density [PSAD] if applicable): John Hopkins University (JHU; T1c, 3+3 GS, 2 PC, 50% SCP, PSAD 0.15); University of Toronto (UT; 3+3 GS, 10 ng/ml PSA); University of California (UCSF; T2a, 3+3 GS, <10 ng/ml PSA, <33% PC); Prostate Cancer Research International Active Surveillance by the European Randomized Study of Screening for Prostate Cancer (PRIAS; T2, 3+3 GS, < 0 ng/ml PSA, 2 PC, PSAD <0.2); Royal Mardsen Hospital (RMH; T2a, 3+4 GS, 15 ng/ml PSA, 50% PC); Memorial Sloan-Kettering Cancer Center (MSKCC; T2a, 3+3 GS, <10 ng/ml PSA, 3 PC, 50% SCP); University of Miami (UM; T2, 3+3 GS, 10 ng/ml PSA, 2 PC, 20% SCP) We compared proportions of unfavorable pathological tumor stage ( pT3 and/or N1) in final RP pathology and 5-year biochemical recurrence rates (BCR) after RP with Kaplan Meier curves among those protocols. RESULTS: For AS criteria by JHU, UT, UCSF, ERSPC PRIAS, RMH, MSKCC and UM the respective rates for non-organ confined disease were: 5.5%, 13.8%, 10.2%, 7.9%, 17.8%, 9.0% and 6.9%. Similarly, the respective rates of 5-year BCR-free survival (95% CI) were: 93.6% (91.0-96.3), 88.9% (87.1-90.7), 91.5% (89.7-93.4), 92.5% (90.6-94.5), 86.6% (85.1-88.2), 91.0% (88.7-93.4) and 91.5% (88.8- 94.2). Overall, the log-rank test showed at least statistically significant difference between the most vs. least restrictive protocol by JHU vs. RMH. CONCLUSIONS: When using RP patients for comparing different AS protocols, significant differences with a great spectrum of non-organ disease and BCR free survival exist. These differences should be considered when different AS criteria are selected for balancing over- and deferred treatment. e60 THE JOURNAL OF UROLOGY â Vol. 195, No. 4S, Supplement, Friday, May 6, 2016