Contemporary approach to active surveillance for favorable risk prostate cancer

Klotz, Laurence

doi:10.1016/j.ajur.2018.12.003

Cited by 38 publications

(28 citation statements)

References 55 publications

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“…Indices of psychological morbidity for men with PCa undergoing AS are higher at diagnosis and during the early stages of AS . Findings from a prospective cohort study of 413 men on AS showed a 29% risk of cancer‐specific anxiety within the first year of AS, which significantly decreased within 2 years .…”

Section: Introductionmentioning

confidence: 99%

Associations between self‐reported physical activity, quality of life, and emotional well‐being in men with prostate cancer on active surveillance

et al. 2020

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Objective The relationship between physical activity (PA) and quality of life (QOL) relative to active treatment for prostate cancer (PCa) has been well‐studied; however, little is known about this relationship during active surveillance (AS). Moreover, whether PA is associated with better emotional well‐being (EWB) in men with low‐risk PCa requires further investigation. Accordingly, we examined the association between self‐reported PA and the average change in QOL and EWB over time during AS. Methods A total of 630 men on AS were included in this retrospective, longitudinal study from AS initiation until AS discontinuation. Generalized estimated equations were used to determine the association between self‐reported PA (independent variable) and QOL and EWB (dependent variables) over time, adjusting for participants' age. Results QOL was higher over time in active (trueβ^(95%CI) = 1.14 (0.11, 2.16), P = .029) and highly active participants (trueβ^(95%CI) = 1.62 (0.58, 2.67), P = .002) compared to their inactive counterparts. Highly active participants had 55% greater odds of experiencing high EWB relative to inactive participants (OR (95%CI) = 1.55 (1.11, 2.16), P = .010). In men with low EWB at baseline (median = 3 months after diagnosis), the highest levels of PA (>1000 metabolic equivalent‐minutes per week) were associated with high EWB over time (OR (95%CI) = 2.17 (1.06, 4.46), P = .034). Conclusions These data further support the importance of PA as a supportive care strategy for men on AS. Our findings suggest that engaging in higher volumes of PA post‐diagnosis may be beneficial particularly for men exhibiting low emotional well‐being early on during AS.

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Section: Introductionmentioning

confidence: 99%

Associations between self‐reported physical activity, quality of life, and emotional well‐being in men with prostate cancer on active surveillance

et al. 2020

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“…Therefore, even if early intermediate patients were excluded, the histological reclassification rate of true low-risk patients in the PREFERE trial was 35%, which is twice as high as in the PRIAS trial. This may be explained by the following points: (1) sampling error at the time of the first biopsy; (2) two, instead of only one, recommended confirmation rebiopsies within the first 2 years of the PREFERE trial; and (3) different selection criteria.…”

Section: Discussionmentioning

confidence: 99%

Termination rates and histological reclassification of active surveillance patients with low- and early intermediate-risk prostate cancer: results of the PREFERE trial

et al. 2020

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Purpose Active surveillance (AS) strategies for patients with low-and early intermediate-risk prostate cancer are still not consistently defined. Within a controlled randomized trial, active surveillance was compared to other treatment options for patients with prostate cancer. Aim of this analysis was to report on termination rates of patients treated with AS including different grade groups. Methods A randomized trial comparing radical prostatectomy, active surveillance, external beam radiotherapy and brachytherapy was performed from 2013 to 2016 and included 345 patients with low-and early intermediate-risk prostate cancer (ISUP grade groups 1 and 2). The trial was prematurely stopped due to slow accrual. A total of 130 patients were treated with active surveillance. Among them, 42 patients were diagnosed with intermediate-risk PCA. Reference pathology and AS quality control were performed throughout. Results After a median follow-up time of 18.8 months, 73 out of the 130 patients (56%) terminated active surveillance. Of these, 56 (77%) patients were histologically reclassified at the time of rebiopsy, including 35% and 60% of the grade group 1 and 2 patients, respectively. No patients who underwent radical prostatectomy at the time of reclassification had radical prostatectomy specimens ≥ grade group 3. Conclusion In this prospectively analyzed subcohort of patients with AS and conventional staging within a randomized trial, the 2-year histological reclassification rates were higher than those previously reported. Active surveillance may not be based on conventional staging alone, and patients with grade group 2 cancers may be recommended for active surveillance in carefully controlled trials only.

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“…Risk calculators, such as the Canary Prostate Active Surveillance Study risk calculation 87 , the Johns Hopkins model 88 and the PRIAS model 89 have been developed in an effort to address this need. These AS risk calculators can selectively predict men at risk of progression and balance reclassification detection with the number of surveillance biopsies by incorporating the serial measurement of the monitoring tools into the prediction model (for example, patient age, prostate volume, PSA, time since diagnosis, number of previous biopsies and all previous biopsy results) [90][91][92][93][94] .…”

Section: Research Need Number 2 Develop Indicators To Better Stratifymentioning

confidence: 99%

The Movember Prostate Cancer Landscape Analysis: an assessment of unmet research needs

et al. 2020

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Prostate cancer is the second most diagnosed solid-organ malignancy in men 1 , with >1.2 million new cases and 358,989 deaths reported worldwide in 2018 (ref. 2). Since 2005, the global men's health charity Movember has invested in a variety of very influential programmes in biomedical research, survivorship and clinical quality and has set ambitious organizational objectives to work with its global partners to halve the number of deaths from prostate cancer and to halve the number of men facing ongoing adverse effects from treatment by 2030. In order to transform these aspirations into reality, Movember needs to understand the gaps and opportunities in the field. Given that the last published analysis of the field was conducted by Tindall and Scardino 3 ~20 years ago, Movember's Global Scientific Committee (GSC) recommended that the Movember Biomedical Research Team commission a formal landscape analysis to assess the international prostate cancer research field in order to optimize future research investment and maximize biomedical research outcomes. The scope of this analysis was restricted to the role of Movember as a funder whose purpose is to positively change clinical practice in the prostate cancer biomedical research field for the benefit of men. In this Consensus Statement, we present the results and conclusions of Movember's prostate cancer global landscape analysis. Methods The Movember prostate cancer landscape analysis commenced in April 2017. A sequential research design was used, in which insights gathered from stakeholder

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Contemporary approach to active surveillance for favorable risk prostate cancer

Cited by 38 publications

References 55 publications

Associations between self‐reported physical activity, quality of life, and emotional well‐being in men with prostate cancer on active surveillance

Associations between self‐reported physical activity, quality of life, and emotional well‐being in men with prostate cancer on active surveillance

Termination rates and histological reclassification of active surveillance patients with low- and early intermediate-risk prostate cancer: results of the PREFERE trial

The Movember Prostate Cancer Landscape Analysis: an assessment of unmet research needs

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