Related Experiment Video
Updated: Apr 21, 2026
05:19
A New Technique for Treating Low-risk Prostate Cancer—Super Active Surveillance
Published on: November 7, 2025
1.1K
Who, When, and How: Watchful Waiting in the ERSPC Rotterdam
Jeroen J Lodder1, Esmée F H Mulder1, Sebastiaan Remmers1
1Department of Urology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands.
European Urology Open Science
|April 20, 2026
Summary
Watchful waiting (WW) for prostate cancer requires individualized follow-up. Long-term data shows significant differences in androgen deprivation therapy (ADT) initiation rates based on risk group, highlighting the need for tailored monitoring strategies.
Area of Science:
- Urology
- Oncology
- Prostate Cancer Management
Background:
- Limited long-term data exists on patient progression under watchful waiting (WW).
- Understanding prognostic factors for androgen deprivation therapy (ADT) initiation is crucial for optimizing WW strategies.
Purpose of the Study:
- To evaluate watchful waiting (WW) practices in prostate cancer patients.
- To identify prognostic factors influencing the need for androgen deprivation therapy (ADT).
- To predict long-term ADT-free survival based on patient risk stratification.
Main Methods:
- Analysis of 18-year follow-up data from the European Randomized Study for Prostate Cancer (ERSPC).
- Stratification of patients by European Association of Urology (EAU) risk groups.
- Utilized a Fine-Gray competing risk model to identify predictors of ADT initiation.
Main Results:
- At 18 years, cumulative ADT initiation was 6.6% (low risk), 33% (intermediate risk), and 55% (high risk).
- Prostate-specific antigen (PSA), grade group, and T-stage were significant predictors for ADT.
- Predicted 18-year ADT-free survival varied widely, from 90% (low risk) to 35% (high risk).
Conclusions:
- Individualized follow-up schedules for watchful waiting (WW) are recommended.
- Monitoring should consider patient and tumor characteristics to balance detection of progression with avoidance of unnecessary visits.
