Long-term outcomes of active surveillance for prostate cancer: The Memorial Sloan Kettering Cancer Center experience 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: Long-term outcomes of active surveillance for prostate cancer: The Memorial Sloan Kettering Cancer Center experience
Abstract: Purpose: We report oncologic outcomes for men with Grade Group 1 prostate cancer managed with active surveillance at a tertiary cancer center. Materials and Methods: A total of 2,907 patients were managed with active surveillance between 2000 and 2017, of whom 2,664 had Grade Group 1 disease. Patients were recommended confirmatory biopsy to verify eligibility and were followed semiannually with prostate specific antigen, digital rectal examination and review of symptoms. Magnetic resonance imaging was increasingly used in recent years. Biopsy was repeated every 2 to 3 years or after a sustained prostate specific antigen increase or changes in magnetic resonance imaging/digital rectal examination. The Kaplan-Meier method was used to estimate probabilities of treatment, progression and development of metastasis. Results: Median patient age at diagnosis was 62 years. For men with Grade Group 1 prostate cancer the treatment-free probability at 5, 10 and 15 years was 76% (95% CI 74-78), 64% (95% CI 61-68) and 58% (95% CI 51-64), respectively. At 5, 10 and 15 years there were 1,146, 220 and 25 men at risk for metastasis, respectively. Median followup for those without metastasis was 4.3 years (95% CI 2.3-6.9). Distant metastasis developed in 5 men. Upon case note review only 2 of these men were deemed to have disease that could have been cured on immediate treatment. The risk of distant metastasis was 0.6% (95% CI 0.2-2.0) at 10 years. Conclusions: Active surveillance is a safe strategy over longer followup for appropriately selected patients with Grade Group 1 disease following a well-defined monitoring plan.
Keywords: prostatic neoplasms; watchful waiting; management; trends; men; cohort; intermediate; worldwide
Journal Title: Journal of Urology
Volume: 203
Issue: 6
ISSN: 0022-5347
Publisher: Elsevier Science, Inc.  
Date Published: 2020-06-01
Start Page: 1122
End Page: 1127
Language: English
ACCESSION: WOS:000539218300073
DOI: 10.1097/ju.0000000000000713
PROVIDER: wos
PUBMED: 31868556
PMCID: PMC7480884
Notes: Article -- Source: Wos
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MSK Authors
  1. Vincent Laudone
    137 Laudone
  2. Peter T Scardino
    671 Scardino
  3. Karim Abdelkrim Touijer
    259 Touijer
  4. Andrew J Vickers
    882 Vickers
  5. Daniel D. Sjoberg
    234 Sjoberg
  6. Behfar Ehdaie
    174 Ehdaie
  7. James Eastham
    538 Eastham
  8. Samson W Fine
    462 Fine
  9. Victor Reuter
    1228 Reuter
  10. Sigrid Viktoria Carlsson
    221 Carlsson
  11. Nicole E Benfante
    161 Benfante
  12. Maha Mamoor
    15 Mamoor
  13. Ricardo Goncalves Alvim
    25 Alvim