TAPG – Trans Atlantic Prostate Group

Full Title: Prognostic Factors in Prostate Cancer for Patients Treated by Watchful Waiting

Study acronym: TAPG

Sponsor: Queen Mary University of London

Study Start Date: 1999

Estimated Number of Participants: ~ 3,350

Contact: bartsctu-fup@qmul.ac.uk

Registration: https://clinicaltrials.gov/study/NCT03912883

Background:

The TAPG study retrospectively examines men diagnosed with clinically localised prostate cancer between 1990 and 2006. It draws on data from regional UK cancer registries and hospital records. Tissue samples (from transurethral resection of the prostate (TURP) or needle biopsy) and registry data were collected for analysis. The study investigates prognostic factors in patients with clinically localised prostate cancer who were under 76 years old at diagnosis and had not shown evidence of metastatic disease. By analysing historical patient data, the study seeks to improve understanding of which factors best predict disease progression and outcomes for men receiving conservative treatment. The study also aims to develop models that predict death from prostate cancer in patients managed conservatively, using standard clinical factors such as PSA levels, Gleason grade, and clinical stage.

Purpose of the Study:

The study seeks to identify which clinical, pathological or molecular factors (beyond traditional markers) best predict outcomes - notably death from prostate cancer or disease progression - in men managed conservatively (watchful waiting). Standard factors under review include baseline PSA level, Gleason grade and clinical stage at diagnosis. A secondary aim is to explore whether the addition of other pathological, biological, or molecular markers can improve prediction of disease recurrence beyond standard clinical measures.

Study Approach:

Eligible patients’ tissue samples including transurethral resection of the prostate (TURP) and needle biopsies were sent to the TAPG coordinating office for additional testing. No direct patient involvement or contact was required, as TAPG is a retrospective, observational cohort study.

Data was originally collected from regional cancer registries and hospital sites. Since 2019, data has also been sourced from NHS digital registries, including cancer and mortality records. This comprehensive dataset allows researchers to evaluate the effectiveness of prostate cancer interventions and supports decision-making for early-stage prostate cancer treatment.

Key Findings:

• Analysis from the cohort has identified that Gleason score is an important predictor of prostate-cancer specific mortality. 

• Baseline PSA levels and, to a lesser extent, clinical stage at diagnosis also contribute additional predictive value. 

• Earlier reports on local disease progression (in conservatively managed patients) found that around 15% of men developed symptomatic progression requiring treatment within 10 years of diagnosis.

 

What This Means:

By combining long-term follow-up data with detailed pathological and clinical information, TAPG helps doctors and researchers better understand which early prostate cancers are likely to remain stable and which may worsen - potentially guiding management decisions between conservative monitoring and active treatment.

Future Results:

Further analyses are ongoing. New findings (including potential molecular prognostic markers) will be published here when available.

Participant Information:

If you believe you were included in the TAPG cohort and wish to withdraw consent for further follow-up data use, please contact: bartsctu‑fup@qmul.ac.uk

(Estimated) Study Completion Date:

• 01/01/2030