A new study reveals favorable long-term outcomes for active surveillance of lower risk prostate cancer.
During a 10- to 15-year follow-up period, researchers found just 1.5% reported cases of prostate cancer metastasis and 1.3% reported deaths from the disease among a cohort of 993 men with lower risk prostate cancer on active surveillance.
In this group, mortality from other causes was 9.2 times greater than the risk of dying from prostate cancer. In light of these findings, published in the Journal of Clinical Oncology, active surveillance seems a safe option in select patients.
Ideally, active surveillance would prevent overtreatment of prostate cancers that progress only slowly. Overtreatment sometimes leads to incontinence, erectile dysfunction and other problems.
New imaging techniques and molecular biomarkers might help determine which patients should be considered for active surveillance.
In the study, treatment was offered to patients for a prostate-specific antigen (PSA) doubling time of less than 3 years, Gleason score progression, or unequivocal clinical progression.
1. In a cohort of more than 900 low-risk prostate cancer patients followed for up to 15 years, 2.8% of patients developed metastatic disease and 1.5% died of prostate cancer.
2. The relative likelihood of dying from other causes compared to dying from prostate cancer death in this cohort was 9.2 to 1.
Evidence Rating Level: 2 (Good)
Study Rundown: Prostate cancer is the most common malignancies in men, with a lifetime risk of 1 in 7. Active surveillance (AS) is the process of forgoing initial definitive treatment for delayed definitive intervention when specific signs of disease progression has occurred.