Results The AUA ( American Urological Association ) , ASTRO , and SUO ( Society of Urologic Oncology ) formulated an evidence ‐based guideline based on a risk stratified clinical framework for the management of localized prostate cancer .
Purpose This guideline is structured to provide a clinical framework stratified by cancer severity to facilitate care decisions and guide the specifics of implementing the selected management options .
The summary presented represents Part I of the two‐part series dedicated to Clinical ly Localized Prostate Cancer : AUA/ASTRO/SUO Guideline discussing risk stratification and care options by cancer severity .
Long-term follow-up of a large active surveillance cohort of patients with prostate cancer.
PURPOSE Active surveillance is increasingly accepted as a treatment option for favorable-risk prostate cancer . Long-term follow-up has been lacking . In this study , we report the long-term outcome of a large active surveillance protocol in men with favorable-risk prostate cancer . PATIENTS AND METHODS In a prospect i ve single-arm cohort study carried out at a single academic health sciences center , 993 men with favorable- or intermediate-risk prostate cancer were managed with an initial expectant approach . Intervention was offered for a prostate-specific antigen ( PSA ) doubling time of less than 3 years , Gleason score progression , or unequivocal clinical progression . Main outcome measures were overall and disease-specific survival , rate of treatment , and PSA failure rate in the treated patients . RESULTS Among the 819 survivors , the median follow-up time from the first biopsy is 6.4 years ( range , 0.2 to 19.8 years ) . One hundred forty-nine ( 15 % ) of 993 patients died , and 844 patients are alive ( censored rate , 85.0 % ) . There were 15 deaths ( 1.5 % ) from prostate cancer . The 10- and 15-year actuarial cause-specific survival rates were 98.1 % and 94.3 % , respectively . An additional 13 patients ( 1.3 % ) developed metastatic disease and are alive with confirmed metastases ( n = 9 ) or have died of other causes ( n = 4 ) . At 5 , 10 , and 15 years , 75.7 % , 63.5 % , and 55.0 % of patients remained untreated and on surveillance . The cumulative hazard ratio for nonprostate-to-prostate cancer mortality was 9.2:1 . CONCLUSION Active surveillance for favorable-risk prostate cancer is feasible and seems safe in the 15-year time frame . In our cohort , 2.8 % of patients have developed metastatic disease , and 1.5 % have died of prostate cancer . This mortality rate is consistent with expected mortality in favorable-risk patients managed with initial definitive intervention
Results The AUA ( American Urological Association ) , ASTRO , and SUO ( Society of Urologic Oncology ) formulated an evidence ‐based guideline based on a risk stratified clinical framework for the management of localized prostate cancer .
Purpose This guideline is structured to provide a clinical framework stratified by cancer severity to facilitate care decisions and guide the specifics of implementing the selected management options .
The summary presented represents Part I of the two‐part series dedicated to Clinical ly Localized Prostate Cancer : AUA/ASTRO/SUO Guideline discussing risk stratification and care options by cancer severity .