MP48-08 THE LONG-TERM OUTCOMES OF GRADE GROUPS 2 AND 3 PROSTATE CANCER MANAGED BY ACTIVE SURVEILLANCE: RESULTS FROM A LARGE POPULATION-BASED COHORT

You have accessJournal of UrologyProstate Cancer: Localized: Active Surveillance I (MP48)1 Apr 2019MP48-08 THE LONG-TERM OUTCOMES OF GRADE GROUPS 2 AND 3 PROSTATE CANCER MANAGED BY ACTIVE SURVEILLANCE: RESULTS FROM A LARGE POPULATION-BASED COHORT Patrick Richard*, Saint-denis de-Brampton, Narhari Timishina, Maria Komisarenko, Lisa Martin, Ardalan Ahmad, Shabbir Alibhai, Robert Hamilton, Girish Kulkarni, and Antonio finelli Patrick Richard*Patrick Richard* More articles by this author , Saint-denis de-BramptonSaint-denis de-Brampton More articles by this author , Narhari TimishinaNarhari Timishina More articles by this author , Maria KomisarenkoMaria Komisarenko More articles by this author , Lisa MartinLisa Martin More articles by this author , Ardalan AhmadArdalan Ahmad More articles by this author , Shabbir AlibhaiShabbir Alibhai More articles by this author , Robert HamiltonRobert Hamilton More articles by this author , Girish KulkarniGirish Kulkarni More articles by this author , and Antonio finelliAntonio finelli More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000556440.68613.6eAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Prostate cancer is the most common solid organ cancer among North American men. Traditionally, men diagnosed with prostate cancer were offered treatments in the form of radical prostatectomy, external-beam radiotherapy or brachytherapy. However, natural history studies have shown that only a minority of those with low or intermediate risk disease will develop metastases and/or succumb to the cancer. Thus, active surveillance has become an accepted strategy for low-risk, but debated as to its application in intermediate-risk prostate cancer. Unfortunately, most reports of intermediate-risk prostate cancer managed by active surveillance generally lack long-term follow-up and include small numbers of patients. Thus, the objective of this population-based study was to report the long-term outcomes of men diagnosed with Grade Groups 2 and 3 prostate cancer who were managed expectantly. METHODS: Using administrative datasets and pathology reports, we identified all men who were diagnosed with Grade Groups 2 and 3 prostate cancer and managed expectantly between 2002 and 2011 in Ontario, Canada. The overall survival, cancer-specific survival and treatment-free survival were estimated using cumulative incidence function methods while their associated factors were estimated multivariable Cox regression models. RESULTS: We identified 926 men with GG2 or GG3 PCa that were managed expectantly (active surveillance (n=374) or watchful waiting (n=552)). The 8-year cancer-specific survival was 94% and 89% for the active surveillance and watchful waiting cohorts, respectively. Among men managed by active surveillance, 266 (71%) received treatment after a follow-up of approximately 8 years. Cumulative active surveillance discontinuation rates at 1- and 5-years were 30.5% and 65.1%, respectively. CONCLUSIONS: Expectant management of Grade Groups 2 and 3 PCa may be an option for certain men. Notably for active surveillance patients, the cancer-specific mortality at 8-years was 6%. More importantly, over 65% of men underwent treatment within 5 years. Further studies are required to evaluate which sub-group of patients, based on disease-specific features and competing health risks, would benefit the most from this strategy. Source of Funding: Prostate Cancer Canada Qc, Canada; Toronto, Canada© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e699-e700 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Patrick Richard* More articles by this author Saint-denis de-Brampton More articles by this author Narhari Timishina More articles by this author Maria Komisarenko More articles by this author Lisa Martin More articles by this author Ardalan Ahmad More articles by this author Shabbir Alibhai More articles by this author Robert Hamilton More articles by this author Girish Kulkarni More articles by this author Antonio finelli More articles by this author Expand All Advertisement PDF downloadLoading ...

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