Careful Selection and Close Monitoring of Low-Risk Prostate Cancer Patients on Active Surveillance Minimizes the Need for Treatment

摘要: Abstract Background With the advent of prostate-specific antigen (PSA) screening and increase in number transrectal ultrasound–guided biopsy cores, there has been a dramatic rise incidence low-risk prostate cancer (LRPC). Because >97% men with LRPC are likely to die something other than cancer, it is critical that patients give thought whether early curative treatment only option at diagnosis. Objective To identify group who may not require initial monitor them on our active surveillance (AS) protocol, determine percentage treated outcome analyze quality-of-life data. Design, setting, participants We defined eligible for AS as Gleason ≤6, PSA ≤10, two or fewer cores ≤20% tumor each core. Measurements Kaplan Meier analysis was used predict 5-year free survival. Logistic regression determined predictors treatment. Data sexual function, continence, were obtained analyzed. Results limitations The cohort consisted 230 mean age 63.4 yr; 86% remained follow-up 44 mo. Thirty-two (14%) 33 Twelve had total prostatectomy (TP). pathologic stage these similar initially TP LRPC. Fourteen underwent radiation therapy, six androgen-deprivation therapy. Fifty percent no first rebiopsy, 5% subsequently treated. doubling time clinical No patient progressed after Among patients, 30% incontinence, yet Conclusions If guidelines narrowly include 6, volume one levels few Progression-free survival those be equivalent findings