Active surveillance in prostate cancer in a group of patients assisted at the Rivera Associated Teaching Center for Medical Oncology: Rivera Medical Cooperative (COMERI)
Abstract
Introduction: In Uruguay, prostate cancer ranks first in incidence and third in mortality among men. The majority of these cancers are diagnosed at early stages. Nowadays, active surveillance is an appropriate option for patients with adenocarcinoma of very low risk, low risk, or favorable intermediate risk. Objectives: To describe a population of patients with prostate cancer of very low risk, low risk, or favorable intermediate risk under active surveillance at COMERI. Materials and Methods: Descriptive, observational, retrospective study. Patients with prostate cancer of very low risk, low risk, or favorable intermediate risk treated between 2010 and 2018 at COMERI were included. Data were collected from the electronic clinical registry system. Results: Thirty-three patients were included, with a median age at diagnosis of 74 years. All patients underwent clinical monitoring and PSA determination every 3 months. Digital rectal examination was
performed annually. The median time of active surveillance was 33 months. During follow-up, there were few variations in PSA values. 21% of patients underwent a repeat biopsy during active surveillance, and in all cases, the Gleason score remained unchanged. No patient discontinued active surveillance. Conclusion: In our setting, active surveillance is considered a valid therapeutic option for highly selected patients with prostate cancer of very low risk, low risk, or favorable intermediate risk, and it is well accepted by them.
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References
CHLCC. Resumen Estadístico. TODOS LOS CÁNCERES. Incidencia y Mortalidad periodo 2015-2019. Tendencia de la Mortalidad hasta 2020. https://www.comisioncancer.org.uy/Ocultas/RESUMENESESTADISTICOS- para-los-canceres-mas-frecuentes--uc264 (Fecha de consulta: 1/08/2023)
Sekhoacha M, Riet K, Motloung P, Gumenku L, Adegoke A, Mashele S. Prostate Cancer Review: Genetics, Diagnosis, Treatment Options, and Alternative Approaches. Molecules. 2022;27(17):5730.
Schatten H. Brief Overview of Prostate Cancer Statistics, Grading, Diagnosis and Treatment Strategies. Adv Exp Med Biol. 2018;1095:1-14.
National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology. Prostate cancer.
https://www.nccn.org/professionals/physician_gls/default.aspx#prostate (Fecha de acceso 1/8/2023).
Hamdy FC, Donovan JL, Lane JA, Mason M, Metcalfe C, Holding P, et al. 10-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Localized Prostate Cancer. N Engl J Med. 2016;375(15):1415-1424.
Eastham JA, Auffenberg GB, Barocas DA, Chou R, Crispino T, Davis JW,et al. Clinically Localized Prostate Cancer: AUA/ASTRO Guideline, Part II: Principles of Active Surveillance, Principles of Surgery, and Follow-Up. J Urol. 2022;208(1):19-25.
Bekelman JE, Rumble RB, Chen RC, Pisansky TM, Finelli A, Feifer A, et al. Clinically Localized Prostate Cancer: ASCO Clinical Practice Guideline Endorsement of an American Urological Association/American Society for
Radiation Oncology/Society of Urologic Oncology Guideline. J Clin Oncol. 2018;36(32):3251-3258.
Hamdy FC, Donovan JL, Lane JA, Metcalfe C, Davis M, Turner EL, et al. Fifteen-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Prostate Cancer. N Engl J Med. 2023;388(17):1547-1558.
Godtman RA, Holmberg E, Khatami A, Pihl CG, Stranne J, Hugosson J. Long-term Results of Active Surveillance in the Göteborg Randomized, Population-based Prostate Cancer Screening Trial. Eur Urol. 2016;70(5):760-766.
Sanda MG, Cadeddu JA, Kirkby E, Chen RC, Crispino T, Fontanarosa J, et al. Clinically Localized Prostate Cancer: AUA/ASTRO/SUO Guideline. Part II: Recommended Approaches and Details of Specific Care Options. J Urol. 2018;199(4):990-997.
Klotz L, Pond G, Loblaw A, Sugar L, Moussa M, Berman D, et al. Randomized Study of Systematic Biopsy Versus Magnetic Resonance Imaging and Targeted and Systematic Biopsy in Men on Active Surveillance (ASIST): 2-year Postbiopsy Follow-up. Eur Urol. 2020;77(3):311-317.
Schenk JM, Newcomb LF, Zheng Y, Faino AV, Zhu K, Nyame YA, et al. African American Race is Not Associated with Risk of Reclassification during Active Surveillance: Results from the Canary Prostate Cancer Active Surveillance Study. J Urol. 2020;203(4):727-733.
Bates AS, Kostakopoulos N, Ayers J, Jameson M, Todd J, Lukha R, et al. A Narrative Overview of Active Surveillance for Clinically Localised Prostate Cancer. Semin Oncol Nurs. 2020;36(4):151045.
Willemse PM, Davis NF, Grivas N, Zattoni F, Lardas M, Briers E, et al. Systematic Review of Active Surveillance for Clinically Localised Prostate Cancer to Develop Recommendations Regarding Inclusion of Intermediaterisk Disease, Biopsy Characteristics at Inclusion and Monitoring, and Surveillance Repeat Biopsy Strategy. Eur Urol. 2022;81(4):337-346.
Dall'Era MA, Albertsen PC, Bangma C, Carroll PR, Carter HB, Cooperberg MR, et al. Active surveillance for prostate cancer: a systematic review of the literature. Eur Urol. 2012;62(6):976-83.
Walker CH, Marchetti KA, Singhal U, Morgan TM. Active surveillance for prostate cancer: selection criteria, guidelines, and outcomes. World J Urol. 2022;40(1):35-42.
Sypre D, Pignot G, Touzani R, Marino P, Walz J, Rybikowski S, et al. Impact of active surveillance for prostate cancer on the risk of depression and anxiety. Sci Rep. 2022;12(1):12889.
Marzouk K, Assel M, Ehdaie B, Vickers A. Long-Term Cancer Specific Anxiety in Men Undergoing Active Surveillance of Prostate Cancer: Findings from a Large Prospective Cohort. J Urol. 2018;200(6):1250-1255.
Loeb S, Folkvaljon Y, Makarov DV, Bratt O, Bill-Axelson A, Stattin P. Five-year nationwide follow-up study of active surveillance for prostate cancer. Eur Urol. 2015;67(2):233-8.
Kirk PS, Zhu K, Zheng Y, Newcomb LF, Schenk JM, Brooks JD, et al. Treatment in the absence of disease reclassification among men on active surveillance for prostate cancer. Cancer. 2022;128(2):269-274.
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