Factors Associated with Time to Conversion from Active Surveillance to Treatment for Prostate Cancer in a...

Area of Science:

• Urology
• Oncology
• Cancer Research

Background:

• Active surveillance is a management strategy for low-risk prostate cancer.
• Identifying predictors of treatment conversion is crucial for optimizing patient care.

Purpose of the Study:

• To investigate demographic and clinicopathological factors influencing the time to treatment conversion in men with prostate cancer on active surveillance.
• To understand which patient and tumor characteristics are associated with a shorter or longer time to treatment initiation.

Main Methods:

• Analysis of a multi-institutional cohort of 6,775 men with prostate cancer managed on active surveillance.
• Germline genetic analyses were performed on collected data and biospecimens.
• Statistical analysis using adjusted hazard ratios (aHR) to determine associations between parameters and time to conversion.

Main Results:

• A significant proportion (33.4%) of patients converted to treatment within a median follow-up of 6.7 years.
• Earlier conversion was linked to higher Gleason grade groups, elevated PSA levels, advanced tumor stages, and more cancerous biopsy cores.
• Younger age was also associated with earlier conversion, while race and genetic ancestry showed no significant association.

Conclusions:

• Higher-risk clinicopathological features are key predictors of earlier treatment conversion from active surveillance.
• High-volume Gleason grade 1 tumors demonstrated conversion patterns similar to intermediate and high-risk tumors.
• Exploratory analyses indicated no link between self-reported race or genetic ancestry and the time to conversion.