25 February 2015

Study found lower survival for intermediate-risk disease, compared to low-risk cases

MONDAY, Feb. 23, 2015 (HealthDay News) Choosing active surveillance over treatment for prostate cancer may decrease the odds of survival in men with intermediate-risk cancer, a new study says.

The risk of death over 15 years for men with intermediate-risk prostate cancers who chose close monitoring of their disease was nearly four times higher compared to men with low-risk disease, according to the study.

Researchers analyzed data from 945 prostate cancer patients in Canada between 1995 and 2013. All had chosen active surveillance also called watchful waiting of their disease. Almost 250 of the men had intermediate-risk prostate cancer. About 700 had low-risk cancer.

If cancer got worse during watchful waiting, patients were offered radiation therapy or surgery. Eighty-six men in the intermediate-risk group received treatment, according to the researchers.

Overall survival rates after 10 and 15 years were 68 percent and 50 percent for intermediate-risk patients. That compared to 84 and 69 percent for low-risk patients, the study noted.

Overall, the researchers found that patients with intermediate-risk disease were almost 4 times more likely to die than those with low-risk disease.

The study is scheduled to be presented at an upcoming American Society for Clinical Oncology (ASCO) meeting.

"For low-risk patients with prostate cancer managed with active surveillance, the risk of dying of prostate cancer is low, validating this approach for this group of patients," Dr. D. Andrew Loblaw, a radiation oncologist at Sunnybrook Health Sciences Centre in Toronto, said in an ASCO news release.

But, he added, more research is needed to figure out which intermediate-risk patients can safely be monitored and which patients need treatment sooner.

This is the first study to compare long-term outcomes of low- and intermediate-risk prostate cancer patients on active surveillance, according to Loblaw and his colleagues.

Active surveillance is considered a standard approach for prostate cancer patients with low-risk disease, as well as for some intermediate-risk patients, the researchers said.

More information

The American Cancer Society has more about prostate cancer.

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