Active Surveillance for Localized Prostate Cancer: No Increased Mortality, but Higher Rates of Clinical Progression
Am Fam Physician. 2017 Feb 1;95(3):196.
What is the best approach to the management of localized prostate cancer?
This landmark study compared active surveillance with radical prostatectomy or radiation therapy for patients with T1c or T2 prostate cancer. The benefits of active surveillance include avoiding radical therapy in one-half of the patients, with no effect on disease-specific survival or all-cause survival. The potential harms include a greater risk of metastatic disease (three additional cases per 1,000 person-years, corresponding to three additional cases for 100 men followed up for 10 years) and a greater likelihood of clinical progression. An accompanying study (N Engl J Med. 2016;375(15):1425–1437) discusses the effects on quality of life and complications of treatment. (Level of Evidence = 1b)
Clinically localized prostate cancer is defined as stage T1c
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