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From the Spring 2015 Quest

Anew study analyzed 945 patients with prostate cancer managed on active surveillance. Researchers found that men with intermediate-risk cancer had a 3.75 higher chance of dying from prostate cancer than men with low-risk disease within 15 years (11.5% vs. 3.7%). The authors said this is the first study to examine long-term outcomes of patients with low- vs. intermediate-risk prostate cancer managed on active surveillance.

"For low-risk patients with prostate cancer managed with active surveillance, the risk of dying of prostate cancer is low, validating this approach for this group of patients. More research, however, is needed to better characterize those intermediate-risk patients who can safely be monitored on a surveillance program."

- Study author D. Andrew Loblow, M.D., of the Sunnybrook Health Sciences Centre

The 10-year overall survival rates for men with intermediate-risk prostate cancer were 68.4%, compared to 83.6% for men with low-risk disease. The 15- year overall survival rates for men with intermediate-risk prostate cancer were 50.3%, compared to 68.8% for low-risk patients. The lower survival rates for men with intermediate-risk disease suggested these patients had lower life expectancy.

Active surveillance is a globally recognized standard approach for patients with low-risk prostate cancer and select patients with intermediate-risk prostate cancer. Patients on active surveillance have physical examinations, digital rectal examinations, PSA measurements and repeat tumor biopsies.

Men with intermediate-risk cancer had a PSA >10 ng/ml, Gleason score 7 or clinical stage T2b/2c.

The men in the study were on active surveillance between 1995 and 2013 at the Sunnybrook Health Sciences Centre in Canada. Of the subjects, 237 men had intermediate-risk prostate cancer and 708 men had low-risk cancer. Patients whose cancer worsened were offered treatment (radiation or surgery). Eighty-six patients (36.5%) in the intermediate-risk group received treatment.

The findings were presented at the 2015 Genitourinary Cancers Symposium in Orlando, Florida.

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