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Related Concept Videos

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Sometimes we want to see how people change over time, as in studies of human development and lifespan. When we test the same group of individuals repeatedly over an extended period of time, we are conducting longitudinal research. Longitudinal research is a research design in which data-gathering is administered repeatedly over an extended period of time. For example, we may survey a group of individuals about their dietary habits at age 20, retest them a decade later at age 30, and then again...
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Focal Laser Ablation of Prostate Cancer: An Office Procedure
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Long-term Outcomes Following Active Surveillance of Low-grade Prostate Cancer: A Population-based Study Using a

N Timilshina1,2, S M H Alibhai1,2, G Tomlinson1,2

  • 1Department of Medicine, University Health Network, Toronto, Ontario, Canada.

The Journal of Urology
|December 8, 2022
PubMed
Summary
This summary is machine-generated.

Active surveillance for low-risk prostate cancer shows excellent long-term survival, but a slightly higher cancer-specific mortality risk exists. This finding aids in balancing treatment benefits against overtreatment harms.

Keywords:
prostatic neoplasmswatchful waiting

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Area of Science:

  • Oncology
  • Urology
  • Public Health

Background:

  • Active surveillance is a common strategy for managing low-risk prostate cancer.
  • Long-term population-level outcomes data for active surveillance are limited.
  • Understanding these outcomes is crucial for clinical decision-making.

Purpose of the Study:

  • To determine the long-term oncological outcomes in patients with low-risk prostate cancer managed with active surveillance.
  • To compare these outcomes with those of patients receiving initial treatment.
  • To examine the discontinuation rate of active surveillance.

Main Methods:

  • Retrospective, population-based study using linked administrative databases in Ontario, Canada (2002-2014).
  • Identified low-grade prostate cancer patients managed with active surveillance or initial treatment.
  • Compared 10- and 15-year metastasis-free survival, overall survival, and cancer-specific survival using multivariable proportional hazards models and propensity-based matching.

Main Results:

  • The study included 21,282 patients with a median follow-up of 9.8 years.
  • At 10 years, active surveillance patients had metastasis-free survival of 94.2%, overall survival of 88.7%, and cancer-specific survival of 98.1%.
  • Active surveillance was associated with a higher risk of metastasis, overall mortality, and prostate cancer-specific mortality compared to initial treatment in adjusted models.

Conclusions:

  • Active surveillance for low-grade prostate cancer is linked to excellent long-term metastasis-free and overall survival.
  • A slight inferiority in long-term cancer-specific survival (1% worse at 10 years) was observed with active surveillance.
  • These findings necessitate balancing the benefits of active surveillance against the known harms of overtreatment.