Prostate Cancer Active Surveillance Outcomes Vary by Disease Risk

Cancer-specific and overall survival is decreased in men with intermediate-risk versus low-risk tumors.

The 15-year cancer-specific survival rates were 88.5% for the intermediate-risk patients compared with 96.3% for the low-risk patients.
The 15-year cancer-specific survival rates were 88.5% for the intermediate-risk patients compared with 96.3% for the low-risk patients.

ORLANDO, Fla.—Active surveillance for prostate cancer (PCa) is associated with decreased survival among men with intermediate-risk tumors compared with those who have low-risk disease, new findings presented at the 2015 Genitourinary Cancers Symposium suggest.

In a study of 945 PCa patients managed with active surveillance, those with intermediate-risk cancer had a 3.7 times increased risk of dying from the cancer and a 2 times increased risk of death from any cause.

The study population included 237 patients with intermediate-risk disease (defined as men with a PSA level above 10 ng/mL or Gleason score 7 or clinical stage T2b/2c tumors) and 708 patients (76.1%) had low-risk disease. The median follow-up periods for the 2 groups were 6.9 and 6.4 years, respectively.

The 15-year cancer-specific survival rates were 88.5% for the intermediate-risk patients compared with 96.3% for the low-risk patients; the 15-year overall survival rates were 50.3% and 68.8%, respectively. The differences between the groups were statistically significant.

“For low-risk patients with prostate cancer managed with active surveillance, the risk of dying of prostate cancer is low, validating this approach for this group of patients,” said presenting author D. Andrew Loblaw, MD, a radiation oncologist at Sunnybrook Health Sciences Centre in Toronto. “More research, however, is needed to better characterize those intermediate-risk patients who can safely be monitored on an active surveillance program.”

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