Oncological Outcomes Similar Despite Timing of Prostatectomy
(HealthDay News) – Outcomes are similar between men with histologically comparable prostate cancer who receive a radical prostatectomy after a period of active surveillance and those with low-risk disease who undergo immediate prostatectomy, according to a study published in the July issue of The Journal of Urology.
Raj Satkunasivam, MD, from the University of Toronto, and colleagues identified patients on active surveillance treated with radical prostatectomy. They compared active-surveillance patients (289) who were ultimately treated with radical prostatectomy to age-and prostate-specific antigen matched men undergoing immediate radical prostatectomy after a diagnosis of low-risk disease who were candidates for active surveillance (group 1). Patients on active surveillance with progression to Gleason 7 disease were also compared to men treated who had similar de novo disease (group 2).
The researchers found that 14.2% (41 of 289) of active surveillance patients underwent radical prostatectomy after a median of 35.2 months. The radical prostatectomy after active surveillance group had worse pathological outcomes compared to group 1, whereas group 2 and those patients undergoing radical prostatectomy after active surveillance with progression to Gleason 7 disease had similar pathological outcomes. Biochemical recurrence was low and comparable between the radical prostatectomy after active surveillance group and group 1 (2.6% vs. 5.4%; P=0.47) at a median of 3.5 years after radical prostatectomy. Both groups had comparable erectile function and continence.
"Radical prostatectomy after a period of active surveillance does not appear to result in adverse pathological outcomes compared to patients with a similar preoperative pathology," the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.