Long-term outcomes of active surveillance for clinically localized prostate cancer in a community-based setting: results from a prospective non-interventional study - Summary - MDSpire
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Long-term outcomes of active surveillance for clinically localized prostate cancer in a community-based setting: results from a prospective non-interventional study
To investigate the long-term outcomes of active surveillance (AS) for localized prostate cancer in a community setting, emphasizing its effectiveness compared to clinical trials.
Key Findings:
10-year overall survival was estimated at 86% and metastasis-free survival at 97%, indicating strong long-term outcomes.
28 patients (8.5%) died during follow-up, with no prostate cancer-specific deaths, suggesting effective management of the disease.
7 patients (2.1%) developed metastasis, primarily among very-low and intermediate-risk groups, highlighting the need for careful monitoring.
56.8% of patients discontinued AS for invasive treatment, mainly due to biopsy upgrades and PSA elevation, raising questions about the criteria for treatment transition.
Interpretation:
The outcomes of AS in a community setting are comparable to those in clinical trials, indicating its viability as a treatment strategy for localized prostate cancer, with implications for broader adoption in clinical practice.
Limitations:
The study was observational and non-interventional, which may affect generalizability, particularly in diverse patient populations.
The lack of mpMRI usage during the study period may limit the assessment of disease progression, potentially underestimating the risk of metastasis.
Conclusion:
Active surveillance is a safe and effective management strategy for localized prostate cancer in community settings, with low rates of progression and mortality.
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