User login
Men with favorable intermediate-risk prostate cancer could be considered for active surveillance, say the authors of a study, published in JAMA Oncology, showing no significant increase in prostate cancer–specific mortality in this group, compared with those with low-risk disease.
The prospective cohort study in 5,580 men with brachytherapy-treated localized adenocarcinoma of the prostate defined favorable intermediate-risk disease as a Gleason score of 3 + 4 or less, below 50% positive biopsy scores, and one or fewer National Comprehensive Cancer Network determinants of intermediate-risk prostate cancer.
Researchers found no significant increases in prostate cancer–specific or all-cause mortality in the favorable intermediate-risk group, compared with the low-risk group (JAMA Oncology 2015 Feb. 19 [doi:10.1001/jamaoncol.2014.284]).
“This lack of a significant difference in the risk of PCSM [prostate cancer–specific mortality] was evident even though men with low-risk PC had lower median PSA levels, did not have Gleason 3 + 4 disease, and were more likely to have AJCC T1c [American Joint Committee on Cancer T1c] disease, all of which could have caused men with favorable intermediate-risk PC to have a higher risk of PCSM,” wrote Dr. Ann C. Raldow from the Brigham and Women’s Hospital, Boston, and her coauthors.
There were no conflicts of interest declared.
The question of whether active surveillance can be safely extended to patients with intermediate-risk prostate cancer is a subject of great interest; however, it is unclear whether the results of this study would have been the same if the patients had been under active surveillance instead of undergoing brachytherapy.
Further study and improved understanding of the biology of prostate cancer is required, but in the meantime, caution and extreme selectivity must be applied in offering active surveillance to patients with intermediate-risk disease.
Dr. Fred Saad is with the department of surgery at the University of Montreal. These comments are taken from an accompanying editorial (JAMA Oncology 2015 Feb. 19 [doi:10.1001/jamaoncol.2015.103]. There were no conflicts of interest declared.
The question of whether active surveillance can be safely extended to patients with intermediate-risk prostate cancer is a subject of great interest; however, it is unclear whether the results of this study would have been the same if the patients had been under active surveillance instead of undergoing brachytherapy.
Further study and improved understanding of the biology of prostate cancer is required, but in the meantime, caution and extreme selectivity must be applied in offering active surveillance to patients with intermediate-risk disease.
Dr. Fred Saad is with the department of surgery at the University of Montreal. These comments are taken from an accompanying editorial (JAMA Oncology 2015 Feb. 19 [doi:10.1001/jamaoncol.2015.103]. There were no conflicts of interest declared.
The question of whether active surveillance can be safely extended to patients with intermediate-risk prostate cancer is a subject of great interest; however, it is unclear whether the results of this study would have been the same if the patients had been under active surveillance instead of undergoing brachytherapy.
Further study and improved understanding of the biology of prostate cancer is required, but in the meantime, caution and extreme selectivity must be applied in offering active surveillance to patients with intermediate-risk disease.
Dr. Fred Saad is with the department of surgery at the University of Montreal. These comments are taken from an accompanying editorial (JAMA Oncology 2015 Feb. 19 [doi:10.1001/jamaoncol.2015.103]. There were no conflicts of interest declared.
Men with favorable intermediate-risk prostate cancer could be considered for active surveillance, say the authors of a study, published in JAMA Oncology, showing no significant increase in prostate cancer–specific mortality in this group, compared with those with low-risk disease.
The prospective cohort study in 5,580 men with brachytherapy-treated localized adenocarcinoma of the prostate defined favorable intermediate-risk disease as a Gleason score of 3 + 4 or less, below 50% positive biopsy scores, and one or fewer National Comprehensive Cancer Network determinants of intermediate-risk prostate cancer.
Researchers found no significant increases in prostate cancer–specific or all-cause mortality in the favorable intermediate-risk group, compared with the low-risk group (JAMA Oncology 2015 Feb. 19 [doi:10.1001/jamaoncol.2014.284]).
“This lack of a significant difference in the risk of PCSM [prostate cancer–specific mortality] was evident even though men with low-risk PC had lower median PSA levels, did not have Gleason 3 + 4 disease, and were more likely to have AJCC T1c [American Joint Committee on Cancer T1c] disease, all of which could have caused men with favorable intermediate-risk PC to have a higher risk of PCSM,” wrote Dr. Ann C. Raldow from the Brigham and Women’s Hospital, Boston, and her coauthors.
There were no conflicts of interest declared.
Men with favorable intermediate-risk prostate cancer could be considered for active surveillance, say the authors of a study, published in JAMA Oncology, showing no significant increase in prostate cancer–specific mortality in this group, compared with those with low-risk disease.
The prospective cohort study in 5,580 men with brachytherapy-treated localized adenocarcinoma of the prostate defined favorable intermediate-risk disease as a Gleason score of 3 + 4 or less, below 50% positive biopsy scores, and one or fewer National Comprehensive Cancer Network determinants of intermediate-risk prostate cancer.
Researchers found no significant increases in prostate cancer–specific or all-cause mortality in the favorable intermediate-risk group, compared with the low-risk group (JAMA Oncology 2015 Feb. 19 [doi:10.1001/jamaoncol.2014.284]).
“This lack of a significant difference in the risk of PCSM [prostate cancer–specific mortality] was evident even though men with low-risk PC had lower median PSA levels, did not have Gleason 3 + 4 disease, and were more likely to have AJCC T1c [American Joint Committee on Cancer T1c] disease, all of which could have caused men with favorable intermediate-risk PC to have a higher risk of PCSM,” wrote Dr. Ann C. Raldow from the Brigham and Women’s Hospital, Boston, and her coauthors.
There were no conflicts of interest declared.
Key clinical point: There are no significant differences in disease-specific or all-cause mortality in men with favorable intermediate-risk prostate cancer and those with low-risk prostate cancer.
Major finding: Favorable intermediate-risk prostate cancer is not associated with significant increases in mortality, compared with low-risk disease.
Data source: A prospective cohort study in 5,580 men with brachytherapy-treated localized adenocarcinoma of the prostate.
Disclosures: No conflicts of interest were declared.
