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Mp12-06 Long-term Risk of Metastatic Prostate Cancer in Men With Grade Group 2 Managed With Active Surveillance

Year: 2018

Type: article

Abstract: You have accessJournal of UrologyProstate Cancer: Localized: Active Surveillance I1 Apr 2018MP12-06 LONG-TERM RISK OF METASTATIC PROSTATE CANCER IN MEN WITH GRADE GROUP 2 MANAGED WITH ACTIVE SURVEILLANCE Sigrid Carlsson, Nicole Benfante, Ricardo Alvim, Daniel D Sjoberg, Behfar Ehdaie, Peter Scardino, James Eastham, and Karim Touijer Sigrid CarlssonSigrid Carlsson More articles by this author , Nicole BenfanteNicole Benfante More articles by this author , Ricardo AlvimRicardo Alvim More articles by this author , Daniel D SjobergDaniel D Sjoberg More articles by this author , Behfar EhdaieBehfar Ehdaie More articles by this author , Peter ScardinoPeter Scardino More articles by this author , James EasthamJames Eastham More articles by this author , and Karim TouijerKarim Touijer More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.393AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES There is now a growing trend toward expanding active surveillance (AS) inclusion criteria beyond low risk prostate cancer. We sought to study the long-term risk of metastatic development in men with Grade Group 2 being managed with initial AS at Memorial Sloan Kettering Cancer Center. METHODS After IRB approval, our institutional database captured 231 men with Gleason Score 3+4 (Grade Group [GrdGrp] 2) managed with AS during 2000-2017. Confirmatory biopsy was recommended to confirm eligibility and Magnetic Resonance Imaging (MRI) was added in more recent years. Patients were followed semi-annually with PSA, DRE and a review of their health. Biopsy was performed every 2 to 3 years or triggered by changes in MRI, DRE or a sustained PSA-increase. Patient preference or disease progression triggered treatment. Descriptive statistics is reported. Survival was estimated using the Kaplan-Meier method. RESULTS Among the 231 men with GrdGrp 2, the median age at diagnosis was 67 years (IQR 61, 73), the median PSA was 5 ng/mL (IQR 4, 7) and the majority of patients had clinical stage T1c (65%). During follow-up, 69 men received treatment: 36 (52%) radical prostatectomy; 14 radiotherapy (20%), 14 hormones (20%) and 5 focal therapy (5%). The treatment-free survival was 61% (95% CI 52%, 69%) at 5 years and 46% (95% CI 33%, 58%) at 10 years, respectively. Of the 36 patients who underwent RP, 31 (86%) had GrdGrp 2 on pathology and 4 (11%) GrdGrp 3 (1 missing). Three men experienced biochemical recurrence after RP. The overall survival for the entire cohort of 231 men was 97% (95% CI 93%, 99%) at 5 years and 80% (56%, 92%) at 10 years after diagnosis, respectively. The median follow-up for those who did not die was 3.1 years (IQR 1.8, 5.2). No man died of prostate cancer during the follow-up. Three men developed metastasis. The metastasis-free survival was excellent at 98% (95% CI 95%, 99%) both at 5 and 10 years. CONCLUSIONS AS appears to be a safe initial management strategy for carefully selected men with Grade Group 2 prostate cancer managed at a tertiary cancer center. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e137 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Sigrid Carlsson More articles by this author Nicole Benfante More articles by this author Ricardo Alvim More articles by this author Daniel D Sjoberg More articles by this author Behfar Ehdaie More articles by this author Peter Scardino More articles by this author James Eastham More articles by this author Karim Touijer More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Source: The Journal of Urology

DOI: 10.1016/j.juro.2018.02.393