The following article features coverage from the American Urological Association (AUA) 2019 meeting. Click here to read more of Renal & Urology News’ conference coverage.

CHICAGO—Expectant management may be suitable for just a subset of men with intermediate-risk prostate cancer (PCa), investigators reported at the 2019 American Urological Association annual meeting.

Of 926 men from Ontario, Canada with grade group 2 or 3 PCa, 374 chose active surveillance (AS) and 552 watchful waiting (WW). At 8 years after diagnosis, 6% of AS patients and 11% of WW patients had died from PCa, Ardalan E. Ahmad, MD, of the University Health Network and University of Toronto, and colleagues reported. Multivariate analysis showed that older age (in 10 year increments), higher Gleason group at diagnosis (3 vs 2), and having more than 50% of cores positive were significantly associated with a 1.6-, 1.8-, and 2.1-fold increased risk of PCa mortality, respectively.

In addition, 71% of men on AS eventually required treatment. AS was discontinued by 30.5% of patients within 1 year and 65.1% by 5 years.

“Men with localized intermediate-risk prostate cancer opting for active surveillance have a high likelihood of progressing to definitive therapy at 5 years and dying of prostate cancer at 8 years,” Dr Ahmad told Renal & Urology News. “Patients considering expectant management should be counseled thoroughly about the potential benefits and harms of this approach and the high likelihood of eventually undergoing treatment.”


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Additional studies to characterize suitable candidates with intermediate-risk PCa that can be safely managed with active surveillance are necessary, he said.

Read more of Renal & Urology News’ coverage of the AUA 2019 meeting by visiting the conference page.

Reference

Richard P, de-Brampton S, Timishina N, et al. The long-term outcomes of grade groups 2 and 3 prostate cancer managed by active surveillance: Results from a large population-based cohort. Presented at the 2019 American Urological Association annual meeting held May 3-6 in Chicago. Abstract MP48-08.