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Acknowledging unreported problems with active surveillance for prostate cancer: a prospective single-centre observational study.

Abstract：

OBJECTIVE:To report outcomes of patients with localised prostate cancer (PCa) managed with active surveillance (AS) in a standard clinical setting. DESIGN:Single-centre, prospective, observational study. SETTING:Non-academic, average-size hospital in Switzerland. PARTICIPANTS:Prospective, observational study at a non-academic, average-size hospital in Switzerland. Inclusion and progression criteria meet general recommendations. 157 patients at a median age of 67 (61-70) years were included from December 1999 to March 2012. Follow-up (FU) ended June 2013. RESULTS:Median FU was 48 (30-84) months. Overall confirmed reclassification rate was 20% (32/157). 20 men underwent radical prostatectomy with 1 recurrence, 11 had radiation therapy with 2 prostate-specific antigen relapses, and 1 required primary hormone ablation with a fatal outcome. Kaplan-Meier estimates for those remaining in the study showed an overall survival of 92%, cancer-specific survival of 99% and reclassification rate of 41%. Dropout rate was 36% and occurred at a median of 48 (21-81) months after inclusion. 68 (43%) men are still under AS. CONCLUSIONS:Careful administration of AS can and will yield excellent results in long-term management of PCa, and also helps physicians and patients alike to balance quality of life and mortality. Our data revealed significant dropout from FU. Patient non-compliance can be a relevant problem in AS.

journal_name

BMJ Open

journal_title

BMJ open

authors

Hefermehl LJ,Disteldorf D,Lehmann K

doi

10.1136/bmjopen-2015-010191

subject

Has Abstract

pub_date

2016-02-17 00:00:00

pages

e010191

issue

2

issn

2044-6055

pii

bmjopen-2015-010191

journal_volume

6

pub_type

杂志文章

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