Synapse - Risk of metastasis in men with grade group 2 prostate cancer managed with active surveillance at a tertiary cancer center

Risk of metastasis in men with grade group 2 prostate cancer managed with active surveillance at a tertiary cancer center Journal Article

Authors:	Carlsson, S.; Benfante, N.; Alvim, R.; Sjoberg, D. D.; Vickers, A.; Reuter, V. E.; Fine, S. W.; Vargas, H. A.; Wiseman, M.; Mamoor, M.; Ehdaie, B.; Laudone, V.; Scardino, P.; Eastham, J.; Touijer, K.
Article Title:	Risk of metastasis in men with grade group 2 prostate cancer managed with active surveillance at a tertiary cancer center
Abstract:	Purpose: We studied the risk of metastatic prostate cancer development in men with Grade Group 2 disease managed with active surveillance at Memorial Sloan Kettering Cancer Center. Materials and Methods: A total of 219 men with Grade Group 2 prostate cancer had disease managed with active surveillance between 2000 and 2017. Biopsy was performed every 2 to 3 years, or upon changes in magnetic resonance imaging, prostate specific antigen level or digital rectal examination. The primary outcome was development of distant metastasis. The Kaplan-Meier method was used to estimate treatment-free survival. Results: Median age at diagnosis was 67 years (IQR 61-72), median prostate specific antigen was 5 ng/ml (IQR 4-7) and most patients (69%) had nonpalpable disease. During followup 64 men received treatment, including radical prostatectomy in 36 (56%), radiotherapy in 20 (31%), hormone therapy in 3 (5%) and focal therapy in 5 (8%). Of the 36 patients who underwent radical prostatectomy 32 (89%) had Grade Group 2 disease on pathology and 4 (11%) had Grade Group 3 disease. Treatment-free survival was 61% (95% CI 52-70) at 5 years and 49% (95% CI 37-60) at 10 years. Three men experienced biochemical recurrence, no men had distant metastasis and no men died of prostate cancer during the followup. Median followup was 3.1 years (IQR 1.9-4.9). Conclusions: Active surveillance appears to be a safe initial management strategy in the short term for carefully selected and closely monitored men with Grade Group 2 prostate cancer treated at a tertiary cancer center. Definitive conclusions await further followup.
Keywords:	prostatic neoplasms; watchful waiting; follow-up; cohort; intermediate; worldwide; neoplasm grading; term outcomes
Journal Title:	Journal of Urology
Volume:	203
Issue:	6
ISSN:	0022-5347
Publisher:	Elsevier Science, Inc.
Date Published:	2020-06-01
Start Page:	1117
End Page:	1121
Language:	English
ACCESSION:	WOS:000539218300070
DOI:	10.1097/ju.0000000000000742
PROVIDER:	wos
PUBMED:	31909690
PMCID:	PMC7685513
Notes:	Article -- Source: Wos