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A New Technique for Treating Low-risk Prostate Cancer—Super Active Surveillance
Published on: November 7, 2025
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Conditional probability of reclassification in an active surveillance program for prostate cancer
Ridwan Alam1, H Ballentine Carter1, Patricia Landis1
1The James Buchanan Brady Urological Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
The Journal of Urology
|January 10, 2015
Summary
Prostate cancer reclassification risk differs by time on active surveillance. Low-risk patients face higher reclassification after two years, while subsequent non-reclassifying biopsies reduce risk over time.
Area of Science:
- Urology
- Oncology
- Cancer Surveillance
Background:
- Active surveillance is a common strategy for managing low-risk prostate cancer.
- Understanding reclassification risk over time is crucial for optimizing active surveillance protocols.
Purpose of the Study:
- To evaluate the temporal risk of prostate cancer reclassification in men undergoing active surveillance.
- To compare reclassification rates between very low and low-risk prostate cancer groups.
Main Methods:
- Kaplan-Meier analysis and Cox proportional hazards modeling were used.
- Data included 557 very low-risk and 251 low-risk men compliant with prostate biopsies from 1995-2014.
- Primary outcome was reclassification to higher risk by grade or extent.
Main Results:
- Reclassification rates were similar for very low and low-risk groups within the first two years.
- After two years, low-risk patients were 2.4 times more likely to be reclassified (Gleason score > 6).
- Each non-reclassifying biopsy beyond two years decreased the risk of lifetime reclassification by 30-35%.
Conclusions:
- Prostate cancer reclassification risk during active surveillance is time-dependent and varies by initial risk group.
- Initial misclassification contributes to similar reclassification rates in the first two years.
- The risk of reclassification diminishes with continued surveillance and negative biopsies beyond two years.
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