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Watchful Waiting Safe for Some Prostate Cancer Patients
by -- Jane Parry
Updated: Nov 19th 2009
THURSDAY, Nov. 19 (HealthDay News) -- Active surveillance of localized prostate cancer, with treatment introduced if the cancer progresses, is feasible and safe, according to a study published online Nov. 16 in the Journal of Clinical Oncology.
Laurence Klotz, and colleagues at the University of Toronto conducted a study of 450 patients with localized prostate cancer who were all initially assigned to a watchful-waiting protocol, and who underwent definitive intervention if their prostate-specific antigen score doubled in less than three years, their Gleason score progressed, or there was unequivocal clinical progression.
The patients were followed up for a median 6.8 years, and the overall survival rate of the cohort was 78.6 percent, while the 10-year prostate cancer actuarial survival was 97.2 percent, the researchers note. In all, 30 percent of patients were offered definitive therapy because they had been reclassified, and the prostate-specific antigen failure rate among the 117 patients treated radically was 50 percent.
"This strategy provides the benefit of an individualized approach on the basis of the demonstrated risk of clinical or biochemical progression with time," the authors write. "Uncertainty remains regarding the long-term impact of delayed treatment in men reclassified as higher risk after a period of observation and repeat biopsy. This will require results from a prospective, randomized trial comparing surveillance to radical treatment."
Abstract
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