No significant difference in intermediate key outcomes in men with low- and intermediate-risk prostate cancer managed by active surveillance
Abstract Active surveillance (AS) is standard of care for patients with low-risk prostate cancer (PCa), but its feasibility in intermediate-risk patients is controversial. We compared outcomes of low- and intermediate-risk patients managed with multiparametric magnetic resonance imaging (mpMRI)-supp...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2022-04-01
|
| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-022-10741-8 |
| _version_ | 1811289345194196992 |
|---|---|
| author | Karolina Cyll Sven Löffeler Birgitte Carlsen Karin Skogstad May Lisbeth Plathan Martin Landquist Erik Skaaheim Haug |
| author_facet | Karolina Cyll Sven Löffeler Birgitte Carlsen Karin Skogstad May Lisbeth Plathan Martin Landquist Erik Skaaheim Haug |
| author_sort | Karolina Cyll |
| collection | DOAJ |
| description | Abstract Active surveillance (AS) is standard of care for patients with low-risk prostate cancer (PCa), but its feasibility in intermediate-risk patients is controversial. We compared outcomes of low- and intermediate-risk patients managed with multiparametric magnetic resonance imaging (mpMRI)-supported AS in a community hospital. Of the 433 patients enrolled in AS between 2009 and 2016, 358 complied with AS inclusion criteria (Cancer of the Prostate Risk Assessment (CAPRA) score ≤ 5, Gleason grade group (GGG) ≤ 2, clinical stage ≤ cT2 and prostate-specific antigen (PSA) ≤ 20 ng/ml) and discontinuation criteria (histological-, PSA-, clinical- or radiological disease reclassification). Of the 358 patients, 177 (49%) were low-risk and 181 (51%) were intermediate-risk. Median follow-up was 4.2 years. The estimated 5-year treatment-free survival (TFS) was 56% (95% confidence interval [CI] 51–62%). Intermediate-risk patients had significantly shorter TFS compared with low-risk patients (hazard ratio 2.01, 95% CI 1.47–2.76, p < 0.001). There were no statistically significant differences in the rate of adverse pathology, biochemical recurrence-free survival and overall survival between low- and intermediate-risk patients. Two patients developed metastatic disease and three died of PCa. These results suggest that selected patients with intermediate-risk PCa may be safely managed by mpMRI-supported AS, but longer follow-up is necessary. |
| first_indexed | 2024-04-13T03:54:12Z |
| format | Article |
| id | doaj.art-86dbf7325f9f4ceea8b17e6ded8d38a0 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-13T03:54:12Z |
| publishDate | 2022-04-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-86dbf7325f9f4ceea8b17e6ded8d38a02022-12-22T03:03:42ZengNature PortfolioScientific Reports2045-23222022-04-011211910.1038/s41598-022-10741-8No significant difference in intermediate key outcomes in men with low- and intermediate-risk prostate cancer managed by active surveillanceKarolina Cyll0Sven Löffeler1Birgitte Carlsen2Karin Skogstad3May Lisbeth Plathan4Martin Landquist5Erik Skaaheim Haug6Department of Urology, Vestfold Hospital TrustDepartment of Urology, Vestfold Hospital TrustDepartment of Pathology, Vestfold Hospital TrustDepartment of Urology, Vestfold Hospital TrustDepartment of Urology, Vestfold Hospital TrustDepartment of Radiology, Vestfold Hospital TrustDepartment of Urology, Vestfold Hospital TrustAbstract Active surveillance (AS) is standard of care for patients with low-risk prostate cancer (PCa), but its feasibility in intermediate-risk patients is controversial. We compared outcomes of low- and intermediate-risk patients managed with multiparametric magnetic resonance imaging (mpMRI)-supported AS in a community hospital. Of the 433 patients enrolled in AS between 2009 and 2016, 358 complied with AS inclusion criteria (Cancer of the Prostate Risk Assessment (CAPRA) score ≤ 5, Gleason grade group (GGG) ≤ 2, clinical stage ≤ cT2 and prostate-specific antigen (PSA) ≤ 20 ng/ml) and discontinuation criteria (histological-, PSA-, clinical- or radiological disease reclassification). Of the 358 patients, 177 (49%) were low-risk and 181 (51%) were intermediate-risk. Median follow-up was 4.2 years. The estimated 5-year treatment-free survival (TFS) was 56% (95% confidence interval [CI] 51–62%). Intermediate-risk patients had significantly shorter TFS compared with low-risk patients (hazard ratio 2.01, 95% CI 1.47–2.76, p < 0.001). There were no statistically significant differences in the rate of adverse pathology, biochemical recurrence-free survival and overall survival between low- and intermediate-risk patients. Two patients developed metastatic disease and three died of PCa. These results suggest that selected patients with intermediate-risk PCa may be safely managed by mpMRI-supported AS, but longer follow-up is necessary.https://doi.org/10.1038/s41598-022-10741-8 |
| spellingShingle | Karolina Cyll Sven Löffeler Birgitte Carlsen Karin Skogstad May Lisbeth Plathan Martin Landquist Erik Skaaheim Haug No significant difference in intermediate key outcomes in men with low- and intermediate-risk prostate cancer managed by active surveillance Scientific Reports |
| title | No significant difference in intermediate key outcomes in men with low- and intermediate-risk prostate cancer managed by active surveillance |
| title_full | No significant difference in intermediate key outcomes in men with low- and intermediate-risk prostate cancer managed by active surveillance |
| title_fullStr | No significant difference in intermediate key outcomes in men with low- and intermediate-risk prostate cancer managed by active surveillance |
| title_full_unstemmed | No significant difference in intermediate key outcomes in men with low- and intermediate-risk prostate cancer managed by active surveillance |
| title_short | No significant difference in intermediate key outcomes in men with low- and intermediate-risk prostate cancer managed by active surveillance |
| title_sort | no significant difference in intermediate key outcomes in men with low and intermediate risk prostate cancer managed by active surveillance |
| url | https://doi.org/10.1038/s41598-022-10741-8 |
| work_keys_str_mv | AT karolinacyll nosignificantdifferenceinintermediatekeyoutcomesinmenwithlowandintermediateriskprostatecancermanagedbyactivesurveillance AT svenloffeler nosignificantdifferenceinintermediatekeyoutcomesinmenwithlowandintermediateriskprostatecancermanagedbyactivesurveillance AT birgittecarlsen nosignificantdifferenceinintermediatekeyoutcomesinmenwithlowandintermediateriskprostatecancermanagedbyactivesurveillance AT karinskogstad nosignificantdifferenceinintermediatekeyoutcomesinmenwithlowandintermediateriskprostatecancermanagedbyactivesurveillance AT maylisbethplathan nosignificantdifferenceinintermediatekeyoutcomesinmenwithlowandintermediateriskprostatecancermanagedbyactivesurveillance AT martinlandquist nosignificantdifferenceinintermediatekeyoutcomesinmenwithlowandintermediateriskprostatecancermanagedbyactivesurveillance AT erikskaaheimhaug nosignificantdifferenceinintermediatekeyoutcomesinmenwithlowandintermediateriskprostatecancermanagedbyactivesurveillance |