PURPOSE We assessed the outcome of a watchful-waiting protocol with selective delayed intervention by using clinical @entity1486 (PSA), or histologic progression as treatment indications for clinically @entity263 . @entity1 AND METHODS This was a prospective, single-arm, cohort study. @entity1 were managed with an initial expectant approach. Definitive intervention was offered to those @entity1 with a PSA doubling time of less than 3 years, Gleason score progression (to 4 + 3 or greater), or unequivocal clinical progression. Survival analysis and Cox proportional hazard model were applied to the data. Results A total of 450 @entity1 have been observed with active surveillance. Median follow-up was 6.8 years (range, 1 to 13 years). Overall survival was 78.6%. The 10-year @entity263 actuarial survival was 97.2%. Overall, 30% of @entity1 have been reclassified as higher risk and have been offered definitive therapy. Of 117 @entity1 treated radically, the PSA failure rate was 50%, which was 13% of the total cohort. PSA doubling time of 3 years or less was associated with an 8.5-times higher risk of biochemical failure after definitive treatment compared with a doubling time of more than 3 years (P < .0001). The hazard ratio for nonprostate @entity5 to @entity263 mortality was 18.6 at 10 years. CONCLUSION We observed a low rate of @entity263 mortality. Among the @entity1 who were reclassified as higher risk and who were treated, PSA failure was relatively common. Other-cause mortality accounted for almost all of the deaths. Additional studies are warranted to improve the identification of @entity1 who harbor more aggressive disease despite favorable clinical parameters at diagnosis.

Clinical results of long-term follow-up of a large, active surveillance cohort with XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'PATIENTS'] @entity263 :: ('MESH:D011471', 'Disease') :: ['localized prostate cancer', 'prostate cancer'] @entity5 :: ('MESH:D009369', 'Disease') :: ['cancer'] @entity1486 :: ('354', 'Gene') :: ['prostate-specific antigen']
@entity263 :: (MESH:D011471,Disease) :: ['localized prostate cancer']
