According to a recent study published in The Journal of Urology, men undergoing active surveillance for early prostate cancer have considerably low rates of metastases or death from prostate cancer.1
In the long-term, active surveillance is a safe and viable option for men with low-risk and carefully selected intermediate-risk prostate cancer, explained the study authors.2
In this study, researchers sought to determine predictors of biopsy reclassification at specific time points after enrollment on active surveillance. Importantly, biopsy reclassification was defined as Gleason Grade Group 2 or greater on subsequent biopsy.
A total of 1,450 men with clinically low risk prostate cancer prospectively enrolled on active surveillance at the University of California, San Francisco (UCSF) between 1990 and 2018 were identified for evaluation. The average follow-up time was approximately 6.5 years; however, nearly one-fourth of patients were followed for 10 years or longer.
Ultimately, the results demonstrated that risk of metastases during long-term active surveillance was affected by 3 factors:
Gleason grade:On initial biopsies, 90% of men had low-grade prostate cancers and 10% had intermediate-grade cancers. Overall, 99% of patients were alive and without metastases at 7 years. For those with Gleason Grade 2 cancers, this figure was significantly lower (96%).Prostate specific antigen (PSA) velocity: Patients ...