Active surveillance for localized prostate cancer: update of a prospective single-center cohort

Mathias Thostrup; Frederik B Thomsen; Peter Iversen; Klaus Brasso

doi:10.1080/21681805.2017.1380697

Active surveillance for localized prostate cancer: update of a prospective single-center cohort

Mathias Thostrup, Frederik B Thomsen, Peter Iversen, Klaus Brasso

Department of Clinical Medicine

6 Citations (Scopus)

Abstract

OBJECTIVE: The purpose of active surveillance (AS) is to reduce overtreatment of men with localized prostate cancer (PCa) without compromising survival. The objective of this study was to update a large Scandinavian single-center AS cohort. Furthermore, the use of curative treatment and subsequent risk of biochemical recurrence were investigated and compared in men with very low-risk, low-risk and intermediate-risk PCa in the cohort.

MATERIALS AND METHODS: In total, 451 men were followed on AS and monitored with prostate-specific antigen (PSA) tests, digital rectal examinations and rebiopsies. Recommendation of curative treatment was based on protocolled and predefined risk of progression criteria. Biochemical recurrence was defined as PSA ≥0.2 ng/ml after radical prostatectomy and PSA nadir +2 ng/ml after radiotherapy.

RESULTS: Altogether, 34% were defined with very low-risk PCa, 40% with low-risk PCa and 24% with intermediate-risk PCa. The median follow-up was 5.1 years. The estimated 5 year curatively intended treatment-free survival was 60.5% [95% confidence interval (CI) 54.8-66.2%], with no statistically significant difference between men with very low-risk, low-risk or intermediate-risk PCa. The 5 year biochemical recurrence-free survival was 92.3% (95% CI 87.4-97.2), again with no difference between men with very low-risk, low-risk and intermediate-risk PCa.

CONCLUSION: AS for very low- to low-risk localized PCa is feasible and safe within the short to intermediate time frame. Men with intermediate-risk PCa had the same risk of undergoing curative treatment as men with low-risk PCa, without compromising biochemical recurrence-free survival.

Original language	English
Journal	Scandinavian Journal of Urology
Volume	52
Issue number	1
Pages (from-to)	14-19
ISSN	0036-5599
DOIs	https://doi.org/10.1080/21681805.2017.1380697
Publication status	Published - 2 Jan 2018

Keywords

Aged
Cohort Studies
Disease Progression
Humans
Male
Middle Aged
Neoplasm Recurrence, Local
Prospective Studies
Prostate/pathology
Prostate-Specific Antigen/blood
Prostatectomy/methods
Prostatic Neoplasms/mortality
Risk Assessment/methods
Risk Factors
Scandinavian and Nordic Countries
Survival Analysis

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1080/21681805.2017.1380697

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title = "Active surveillance for localized prostate cancer: update of a prospective single-center cohort",

abstract = "OBJECTIVE: The purpose of active surveillance (AS) is to reduce overtreatment of men with localized prostate cancer (PCa) without compromising survival. The objective of this study was to update a large Scandinavian single-center AS cohort. Furthermore, the use of curative treatment and subsequent risk of biochemical recurrence were investigated and compared in men with very low-risk, low-risk and intermediate-risk PCa in the cohort.MATERIALS AND METHODS: In total, 451 men were followed on AS and monitored with prostate-specific antigen (PSA) tests, digital rectal examinations and rebiopsies. Recommendation of curative treatment was based on protocolled and predefined risk of progression criteria. Biochemical recurrence was defined as PSA ≥0.2 ng/ml after radical prostatectomy and PSA nadir +2 ng/ml after radiotherapy.RESULTS: Altogether, 34% were defined with very low-risk PCa, 40% with low-risk PCa and 24% with intermediate-risk PCa. The median follow-up was 5.1 years. The estimated 5 year curatively intended treatment-free survival was 60.5% [95% confidence interval (CI) 54.8-66.2%], with no statistically significant difference between men with very low-risk, low-risk or intermediate-risk PCa. The 5 year biochemical recurrence-free survival was 92.3% (95% CI 87.4-97.2), again with no difference between men with very low-risk, low-risk and intermediate-risk PCa.CONCLUSION: AS for very low- to low-risk localized PCa is feasible and safe within the short to intermediate time frame. Men with intermediate-risk PCa had the same risk of undergoing curative treatment as men with low-risk PCa, without compromising biochemical recurrence-free survival.",

keywords = "Aged, Cohort Studies, Disease Progression, Humans, Male, Middle Aged, Neoplasm Recurrence, Local, Prospective Studies, Prostate/pathology, Prostate-Specific Antigen/blood, Prostatectomy/methods, Prostatic Neoplasms/mortality, Risk Assessment/methods, Risk Factors, Scandinavian and Nordic Countries, Survival Analysis",

author = "Mathias Thostrup and Thomsen, {Frederik B} and Peter Iversen and Klaus Brasso",

year = "2018",

month = jan,

day = "2",

doi = "10.1080/21681805.2017.1380697",

language = "English",

volume = "52",

pages = "14--19",

journal = "Scandinavian Journal of Urology",

issn = "0036-5599",

publisher = "Taylor & Francis",

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TY - JOUR

T1 - Active surveillance for localized prostate cancer

T2 - update of a prospective single-center cohort

AU - Thostrup, Mathias

AU - Thomsen, Frederik B

AU - Iversen, Peter

AU - Brasso, Klaus

PY - 2018/1/2

Y1 - 2018/1/2

N2 - OBJECTIVE: The purpose of active surveillance (AS) is to reduce overtreatment of men with localized prostate cancer (PCa) without compromising survival. The objective of this study was to update a large Scandinavian single-center AS cohort. Furthermore, the use of curative treatment and subsequent risk of biochemical recurrence were investigated and compared in men with very low-risk, low-risk and intermediate-risk PCa in the cohort.MATERIALS AND METHODS: In total, 451 men were followed on AS and monitored with prostate-specific antigen (PSA) tests, digital rectal examinations and rebiopsies. Recommendation of curative treatment was based on protocolled and predefined risk of progression criteria. Biochemical recurrence was defined as PSA ≥0.2 ng/ml after radical prostatectomy and PSA nadir +2 ng/ml after radiotherapy.RESULTS: Altogether, 34% were defined with very low-risk PCa, 40% with low-risk PCa and 24% with intermediate-risk PCa. The median follow-up was 5.1 years. The estimated 5 year curatively intended treatment-free survival was 60.5% [95% confidence interval (CI) 54.8-66.2%], with no statistically significant difference between men with very low-risk, low-risk or intermediate-risk PCa. The 5 year biochemical recurrence-free survival was 92.3% (95% CI 87.4-97.2), again with no difference between men with very low-risk, low-risk and intermediate-risk PCa.CONCLUSION: AS for very low- to low-risk localized PCa is feasible and safe within the short to intermediate time frame. Men with intermediate-risk PCa had the same risk of undergoing curative treatment as men with low-risk PCa, without compromising biochemical recurrence-free survival.

AB - OBJECTIVE: The purpose of active surveillance (AS) is to reduce overtreatment of men with localized prostate cancer (PCa) without compromising survival. The objective of this study was to update a large Scandinavian single-center AS cohort. Furthermore, the use of curative treatment and subsequent risk of biochemical recurrence were investigated and compared in men with very low-risk, low-risk and intermediate-risk PCa in the cohort.MATERIALS AND METHODS: In total, 451 men were followed on AS and monitored with prostate-specific antigen (PSA) tests, digital rectal examinations and rebiopsies. Recommendation of curative treatment was based on protocolled and predefined risk of progression criteria. Biochemical recurrence was defined as PSA ≥0.2 ng/ml after radical prostatectomy and PSA nadir +2 ng/ml after radiotherapy.RESULTS: Altogether, 34% were defined with very low-risk PCa, 40% with low-risk PCa and 24% with intermediate-risk PCa. The median follow-up was 5.1 years. The estimated 5 year curatively intended treatment-free survival was 60.5% [95% confidence interval (CI) 54.8-66.2%], with no statistically significant difference between men with very low-risk, low-risk or intermediate-risk PCa. The 5 year biochemical recurrence-free survival was 92.3% (95% CI 87.4-97.2), again with no difference between men with very low-risk, low-risk and intermediate-risk PCa.CONCLUSION: AS for very low- to low-risk localized PCa is feasible and safe within the short to intermediate time frame. Men with intermediate-risk PCa had the same risk of undergoing curative treatment as men with low-risk PCa, without compromising biochemical recurrence-free survival.

KW - Aged

KW - Cohort Studies

KW - Disease Progression

KW - Humans

KW - Male

KW - Middle Aged

KW - Neoplasm Recurrence, Local

KW - Prospective Studies

KW - Prostate/pathology

KW - Prostate-Specific Antigen/blood

KW - Prostatectomy/methods

KW - Prostatic Neoplasms/mortality

KW - Risk Assessment/methods

KW - Risk Factors

KW - Scandinavian and Nordic Countries

KW - Survival Analysis

U2 - 10.1080/21681805.2017.1380697

DO - 10.1080/21681805.2017.1380697

M3 - Journal article

C2 - 28958194

SN - 0036-5599

VL - 52

SP - 14

EP - 19

JO - Scandinavian Journal of Urology

JF - Scandinavian Journal of Urology

IS - 1

ER -

Active surveillance for localized prostate cancer: update of a prospective single-center cohort

Abstract

Keywords

UN SDGs

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