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 .
Intermediate and Longer-Term Outcomes From a Prospective Active-Surveillance Program for Favorable-Risk Prostate Cancer.
PURPOSE To assess long-term outcomes of men with favorable-risk prostate cancer in a prospect i ve , active-surveillance program . METHODS Curative intervention was recommended for disease reclassification to higher cancer grade or volume on prostate biopsy . Primary outcomes were overall , cancer-specific , and metastasis-free survival . Secondary outcomes were the cumulative incidence of reclassification and curative intervention . Factors associated with grade reclassification and curative intervention were evaluated in a Cox proportional hazards model . RESULTS A total of 1,298 men ( median age , 66 years ) with a median follow-up of 5 years ( range , 0.01 to 18.00 years ) contributed 6,766 person-years of follow-up since 1995 .  Overall , cancer-specific , and metastasis-free survival rates were 93 % , 99.9 % , and 99.4 % , respectively , at 10 years and 69 % , 99.9 % , and 99.4 % , respectively , at 15 years . The cumulative incidence of grade reclassification was 26 % at 10 years and was 31 % at 15 years ; cumulative incidence of curative  intervention was 50 % at 10 years and was 57 % at 15 years . The median treatment-free survival was 8.5 years ( range , 0.01 to 18 years ) . Factors associated with grade reclassification were older age ( hazard ratio [ HR ] , 1.03 for each additional year ; 95 % CI , 1.01 to 1.06 ) , prostate-specific antigen density ( HR , 1.21 per 0.1 unit increase ; 95 % CI , 1.12 to 1.46 ) , and greater number of positive biopsy cores ( HR , 1.47 for each additional positive core ; 95 % CI , 1.26 to 1.69 ) . Factors associated with intervention were prostate-specific antigen density ( HR , 1.38 per 0.1 unit increase ; 95 % CI , 1.22 to 1.56 ) and a greater number of positive biopsy cores ( HR , 1.35 for one additional positive core ; 95 % CI , 1.19 to 1.53 ) . CONCLUSION Men with favorable-risk prostate cancer should be informed of the low likelihood of harm from their diagnosis and should be encouraged to consider surveillance rather than curative 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 .