OBJECTIVES: To evaluate the acceptance of active monitoring by patients treated in our healthcare community and to report the clinical results of an active surveillance program in patients with low-risk prostate cancer.
MATERIAL AND METHODS: Prospective study of patients enrolled in an active surveillance programme at our centre between 2004 and 2012. The inclusion criteria were PSA < 10ng/ml, Gleason score ≤ 6, clinical stage T1c/T2a, ≤ 2 positive cores, and no more than 50% of the core being affected. Curative treatment was proposed when faced with pathological progression over the course of the monitoring.
RESULTS: In 2011, only 17% of the total number of potential candidate patients rejected their inclusion in a surveillance programme and were treated actively. We analysed a series of 144 patients included in our active surveillance protocol. The mean follow-up time was 3.22 years (SD 2.08). A total of 110 patients (76.3%) remained under active monitoring, with an estimated median treatment-free survival after diagnosis of 6.9 years (95% CI: 6.2-7.6). The percentage of patients who remained free of treatment at 2 and 5 years was 96.3% (95% CI: 92.8%-99.8%) and 70.9% (95% CI: 59.3%-85.5%), respectively. Thirty four patients (23.6%) required curative treatment. The mean time to treatment was 4.6 years (SD 2.3).
CONCLUSIONS: Active surveillance of highly selected patients with low-risk prostate cancer is a valid alternative therapy that is accepted by patients in our community.
Hernández V, Blázquez C, de la Peña E, Pérez-Fernández E, Díaz FJ, Llorente C. Are you the author?
Servicio de Urología, Hospital Universitario Fundación de Alcorcón, Madrid, España.
Reference: Actas Urol Esp. 2013 Apr 22. pii: S0210-4806(13)00081-8.