Seems safe for men at low risk and for select patients at intermediate risk, including those with Gleason 6
THURSDAY, April 14, 2016 (HealthDay News) — For men with prostate cancer, active surveillance seems safe for those at low risk and for select patients at intermediate risk, according to a study published in The Journal of Urology.
Toshihiro Yamamoto, M.D., from the University of Toronto, and colleagues conducted a single-center, prospective cohort study involving men with prostate cancer initially treated with an expectant approach. The patients were followed for metastasis-free survival during a median of 6.3 years.
The researchers found that metastasis developed in 30 of the 980 patients (3.1 percent), including 14 of 211 classified at intermediate risk. Metastases developed in bone and lymph nodes in 18 and 13 patients, respectively. Independent predictors of metastasis included prostate specific antigen doubling time of less than three years (hazard ratio, 3.7), Gleason score 7 (hazard ratio, 3), and a total of three or more positive cores (hazard ratio, 2.7). The intermediate-risk group was at higher risk for metastasis, but no increased risk was seen for patients with Gleason score 6 and prostate specific antigen greater than 10 ng/ml.
“Active surveillance appears safe in patients at low risk and in select patients at intermediate risk, particularly those with Gleason score 6 and prostate specific antigen greater than 10 ng/ml,” the authors write.
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