(HealthDay News) – For men with low-risk prostate cancer, projections show that active surveillance may result in a modest decline in prostate cancer-specific survival, but allows men to remain treatment-free for several more years compared with immediate radical prostatectomy, according to a study published online Sept 24 in Clinical Cancer Research.
Jing Xia, PhD, from the Fred Hutchinson Cancer Research Center in Seattle, and colleagues used a simulation model to project prostate cancer mortality under either active surveillance followed by radical prostatectomy or immediate radical prostatectomy. Information was used from a Johns Hopkins active surveillance cohort (769 men) for time from diagnosis to treatment and associated disease progression; from the Cancer of the Prostate Strategic Urologic Research Endeavor database (3,470 men with T-stage of ≤T2a) for time from radical prostatectomy to recurrence; and from a Johns Hopkins cohort (963 patients) for men whose disease recurred after radical prostatectomy. Results were projected for a hypothetical cohort of men aged 40–90 years with low-risk prostate cancer.
The researchers projected that, in 20 years, 2.8% of men on active surveillance and 1.6% with immediate radical prostatectomy would die of their disease. The corresponding lifetime estimates for prostate cancer death were 3.4 and 2%, respectively. For immediate radical prostatectomy there was an average projected increase of 1.8 months in life expectancy. Men on active surveillance were projected to remain free of treatment for an extra 6.4 years compared with men treated immediately.
“Active surveillance is likely to produce a very modest decline in prostate cancer-specific survival among men diagnosed with low-risk prostate cancer but could lead to significant benefits in terms of quality of life,” the authors write.