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.
