Conservative management on the rise for low-risk prostate cancer

  • Mahal AR & al.
  • Cancer
  • 28 Jun 2019

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • Active Surveillance/Watchful Waiting (AS/WW) increased 4-fold in younger patients with low-risk prostate cancer and 3-fold in older patients during 2010-2015.
  • Overall, AS/WW use in younger patients is less vs in older patients.

Why this matters

  • QoL preservation by avoiding or delaying definitive treatment in low-risk patients appears to be a predominant driver in treatment decisions.

Study design

  • Retrospective study of 50,302 patients with low-risk prostate cancer from Surveillance, Epidemiology, and End Results database during 2010-2015.
  • Funding: None disclosed.

Key results

  • 9973 patients (19.8%) were aged ≤55 years.
  • Median follow-up was 41 months.
  • AS/WW significantly increased during the study period:
    • 4-fold increase in patients aged ≤55 years (8.61% to 34.56%; Ptrend<.001>
    • 3-fold increase in patients aged ≥56 years (15.99% to 43.81%; Ptrend<.001>
  • Rates of definitive RP and RT significantly reduced during 2010-2015 (all Ptrend<.001 style="list-style-type:circle;">
  • Age group ≤55 years: 69.71%-48.38% and 21.68%-17.06%, respectively.
  • Age group ≥56 years: 41.95%-27.5% and 42.06%-28.64%, respectively.
  • Factors associated with AS/WW (all P<.001 were positive cores cores: aor age years and diagnosis after>
  • No difference was observed in cancer-specific mortality by initial management (P=.40).
  • Limitations

    • Lack of QoL measures and comorbidity data.

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