The 5-year results of the Stratified Cancer Active Surveillance programme for men with prostate cancer
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View abstract on PubMed
Summary
This summary is machine-generated.The STRATified CANcer Surveillance (STRATCANS) programme shows risk-stratified active surveillance is safe and effective for prostate cancer over 5 years. This approach offers low treatment rates and tailored monitoring, improving patient outcomes.
Area Of Science
- Urology
- Oncology
- Prostate Cancer Surveillance
Background
- Active surveillance (AS) is a common strategy for managing low-risk prostate cancer.
- Risk stratification at diagnosis is crucial for tailoring AS intensity.
- The STRATified CANcer Surveillance (STRATCANS) programme aimed to refine AS protocols.
Purpose Of The Study
- To report 5-year outcomes of the STRATCANS programme.
- To evaluate the safety and efficacy of risk-stratified AS.
- To assess the impact of National Institute for Health and Clinical Excellence (NICE) Cambridge Prognostic Group (CPG), prostate-specific antigen density, and magnetic resonance imaging (MRI) visibility on progression.
Main Methods
- Men with CPG1 and CPG2 prostate cancer on AS were enrolled.
- Participants were allocated to three follow-up intensity tiers.
- Outcome measures included treatment for CPG≥3 progression, any treatment, conversion to watchful waiting, patient attrition, and mortality.
Main Results
- 72.1% of 297 men remained treatment-free at 5 years.
- No cancer deaths or metastatic events were observed.
- The STRATCANS model (AUC 0.74) outperformed stratification by Grade Group (AUC 0.64) or CPG (0.69) alone in predicting CPG≥3 progression.
Conclusions
- Risk-stratified surveillance using STRATCANS is safe and durable for prostate cancer.
- The programme demonstrates low treatment rates and high patient compliance.
- STRATCANS effectively tailors monitoring intensity based on individual progression risks.
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