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Active Surveillance Effective Strategy for Favorable-Risk Prostate Cancer

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At 10 years after diagnosis, estimated rates of metastasis and prostate cancer-related death were 1.4 and 0.1 percent

By Elana Gotkine HealthDay Reporter

FRIDAY, May 31, 2024 (HealthDay News) — Active surveillance is an effective management strategy for men with favorable-risk prostate cancer, with an estimated rate of metastasis of 1.4 percent at 10 years after diagnosis, according to a study published online May 30 in the Journal of the American Medical Association.

Lisa F. Newcomb, Ph.D., from the Fred Hutchinson Cancer Center in Seattle, and colleagues characterized the long-term oncological outcomes of patients receiving active surveillance in a multicenter cohort study. A cohort of 2,155 men with favorable-risk prostate cancer and no prior treatment were enrolled and followed for a median of 7.2 years.

The researchers found that the incidence of biopsy grade reclassification and treatment were 43 and 49 percent, respectively, at 10 years after diagnosis. Overall, 425 and 396 patients were treated after confirmatory or subsequent surveillance biopsies, respectively, and the five-year recurrence rates were 11 and 8 percent, respectively. Twenty-one participants had progression to metastatic cancer, and three prostate cancer-related deaths occurred. At 10 years after diagnosis, the estimated rates of metastasis or prostate cancer-specific mortality were 1.4 and 0.1 percent, respectively; in the same time period, overall mortality was 5.1 percent.

“The findings show that long-term clinical outcomes of adverse pathology, recurrence, or metastasis are equal in men who undergo treatment immediately following the first biopsy after diagnosis when compared with men who undergo treatment after several years of surveillance,” the authors write.

One author disclosed ties to PatientApps Inc. and participated in medical expert witness review for multiple firms. A second author disclosed ties to the pharmaceutical industry.

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