Active Surveillance for Early Prostate Cancer: Oncological Outcomes at Non-Academic Institution

What is it about?

The study reports the medium-term outcomes of active surveillance (AS) at a non-academic institution adopting the PRIAS protocol. There were no PCa deaths, two patients developed distant metastases, and the 10-year cumulative incidence of metastases was 1.9%. Men not fulfilling at least one PRIAS inclusion criteria had a higher incidence of reclassification, but similar rates of adverse pathological findings at radical prostatectomy. The incidence of long-term metastases was low, reflecting the established concept of safety of AS in patients with Grade Group 1 disease. The study recommends that AS should be proposed to all men with low-grade PCa regardless of whether they are followed at academic institutions or smaller community hospitals. [Some of the content on this page has been created by AI]

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Why is it important?

The research is important because it reports the medium-term outcomes of active surveillance (AS) at a non-academic institution adopting the standardized Prostate Cancer Research International Active Surveillance (PRIAS) protocol. This research highlights the safety of AS in patients with Grade Group 1 (GG1) prostate cancer, as the incidence of metastases and metastasis-free survival were low, similar to the outcomes reported in major AS studies. The research also emphasizes that men with low-grade prostate cancer should be offered AS regardless of whether they are followed at academic institutions or smaller community hospitals. Key Takeaways: 1. The incidence of metastases in men on AS at a non-academic institution is as rare as those reported in established international cohorts. 2. Men followed without stringent inclusion criteria should be counselled about the higher incidence of reclassification and reassured they can expect rates of adverse pathological findings comparable to those fulfilling all criteria. 3. Adherence to surveillance biopsies and protocol-based triggers for discontinuation varied across institutions, highlighting the well-known issue of inter-centre variability of surveillance strategies. 4. The incidence of long-term metastases was low, as reported in major AS studies, reflecting the established concept of safety of AS in patients with GG1 disease.