Delayed radical prostatectomy (RP) performed on patients after a period of active surveillance for localized prostate cancer (PCa) offers excellent 5-year outcomes that compare favorably with upfront RP, according to study findings presented at the Canadian Urological Association 74th Annual Meeting in Quebec City.

Delayed and upfront RP had similar 5-year rates of overall survival (OS), cancer-specific survival (CSS), and biochemical recurrence (BCR)-free survival.

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The study, led by Ardalan E. Ahmad, MD, of Princess Margaret Cancer Centre, University Health Network, University of Toronto, included 170 men who had been on active surveillance but who subsequently underwent RP for clinically significant PCa (ASRP group). Investigators compared this group’s outcomes with those of 405 men who had undergone immediate RP and were matched by clinical and pathologic characteristics. The ASRP group had been on AS for a median 31 months prior to RP. All patients had a minimum of a 6-month follow-up following RP. The median post-RP follow-up for both cohorts was 5.6 years.

Dr Ahmad and his colleagues observed no differences between the groups in the rates of pT3 disease, extracapsular extension, seminal vesicle invasion, BCR, adjuvant radiation therapy, and salvage radiation therapy. The 5-year OS rates in the ASRP and upfront RP cohorts were 98.1% and 99.7%, respectively. The 5-year CSS rates were 100% and 99.7%, respectively. The 5-year BCR-free survival rates were 85.8% and 82.4%, respectively.

Reference

Ahmad AE, Richard P, Leão R, et al. Does time spent on active surveillance adversely affect the pathologic and oncologic outcomes in patients undergoing delayed radical prostatectomy? Presented at the Canadian Urological Association 74th Annual Meeting in Quebec City. Poster MP-4.4.