Related Experiment Video
Updated: Oct 4, 2025
07:25
A Bioluminescent and Fluorescent Orthotopic Syngeneic Murine Model of Androgen-dependent and Castration-resistant Prostate Cancer
Published on: March 6, 2018
13.3K
Metastasis and Mortality in Men With Low- and Intermediate-Risk Prostate Cancer on Active Surveillance
P Travis Courtney1,2, Rishi Deka1,2, Nikhil V Kotha1,2
11Veterans Health Administration San Diego Health Care System, and.
Journal of the National Comprehensive Cancer Network : JNCCN
|February 7, 2022
Summary
Active surveillance (AS) is safe for low-risk prostate cancer. However, intermediate-risk patients on AS face higher metastasis and prostate cancer-specific mortality risks, requiring careful selection for this approach.
Area of Science:
- Urology
- Oncology
- Clinical Research
Background:
- Active surveillance (AS) is established as a safe management strategy for low-risk, localized prostate cancer.
- The safety and efficacy of AS for intermediate-risk prostate cancer patients remain incompletely understood.
- This study investigates outcomes for intermediate-risk prostate cancer managed with AS.
Purpose of the Study:
- To evaluate the safety of active surveillance (AS) in men with intermediate-risk prostate cancer.
- To compare metastasis and mortality rates between low-risk and intermediate-risk prostate cancer patients managed with AS.
- To inform clinical decision-making regarding AS for intermediate-risk prostate cancer.
Main Methods:
- Retrospective cohort study of 9,733 men with prostate cancer managed with AS between 2001-2015 in the Veterans Health Administration.
- Patients were stratified into low-risk, favorable intermediate-risk, and unfavorable intermediate-risk groups based on NCCN criteria.
- Outcomes analyzed included progression to definitive treatment, metastasis, prostate cancer-specific mortality (PCSM), and all-cause mortality using cumulative incidence and competing-risks regression.
Main Results:
- Intermediate-risk patients (10.3% of cohort) had significantly higher 10-year cumulative incidences of metastasis and PCSM compared to low-risk patients.
- Favorable intermediate-risk disease showed a 9.6% metastasis and 3.7% PCSM rate, while unfavorable intermediate-risk disease showed 19.2% metastasis and 11.8% PCSM.
- Multivariable analysis confirmed significantly increased risks of metastasis and PCSM for both favorable and unfavorable intermediate-risk groups compared to low-risk patients (all P<.001).
Conclusions:
- Active surveillance for intermediate-risk prostate cancer is associated with increased risks of metastasis and prostate cancer-specific mortality compared to low-risk disease.
- AS may be a viable option for select favorable intermediate-risk prostate cancer patients.
- Further prospective studies are needed to identify optimal candidates and refine AS protocols for intermediate-risk prostate cancer.
Related Concept Videos
01:21Cancer Survival Analysis
474
Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...
474
01:20Disorders of the Male Reproductive System
1.6K
Men's health issues are increasingly recognized as significant, with several conditions posing common threats. Among these, testicular cancer is especially prevalent in younger men, particularly those aged 20 to 35 years. The disease often manifests as a painless mass in the testicles, sometimes accompanied by a sensation of heaviness or a dull ache.
Prostate disorders are another major concern. These conditions can impair urinary flow due to the prostate's location around the urethra....
Prostate disorders are another major concern. These conditions can impair urinary flow due to the prostate's location around the urethra....
1.6K