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 .
Prospective study of determinants and outcomes of deferred treatment or watchful waiting among men with prostate cancer in a nationwide cohort.
PURPOSE To examine consequences of deferred treatment ( DT ) as initial management of prostate cancer ( PCa ) in a contemporary , prospect i ve cohort of American men diagnosed with PCa . PARTICIPANTS AND METHODS We evaluated deferred treatment for PCa in the Health Professionals Follow-up Study , a prospect i ve study of 51,529 men . Cox proportional hazards models were used to calculate hazard ratios ( HRs ) for time to eventual treatment among men who deferred treatment for more than 1 year after diagnosis . HRs for time to metastasis or death as a result of PCa were compared between patients who deferred treatment and those who underwent immediate treatment within 1 year of diagnosis . RESULTS From among 3,331 cohort participants diagnosed with PCa from 1986 to 2007 , 342 ( 10.3 % ) initially deferred treatment . Of these , 174 ( 51 % ) remained untreated throughout follow-up ( mean 7.7 years ) ; the remainder were treated an average of 3.9 years after diagnosis . Factors associated with progression to treatment among DT patients included younger age , higher clinical stage , higher Gleason score , and higher prostate-specific antigen at diagnosis . We observed similar rates for development of metastases ( n = 20 and n = 199 ; 7.2 v 8.1 per 1,000 person-years ; P = .68 ) and death as a result of PCa ( n = 8 and n = 80 ; 2.4 v 2.6 per 1,000 person-years ; P = .99 ) for DT and immediate treatment , respectively . CONCLUSION In this nationwide cohort , more than half the men who opted for DT remained without treatment for 7.7 years after diagnosis . Older men and men with lesser cancer severity at diagnosis were more likely to remain untreated . PCa mortality did not differ between DT and active treatment patients
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 .