Active surveillance for localized prostate cancer. Nationwide, observational study

Frederik B Thomsen, Henrik Jakobsen, Niels Christian Langkilde, Michael Borre, Erik B Jakobsen, Anders Frey, Lars Lund, Dagmar Lunden, Claus Dahl, J Thomas Helgstrand, Klaus Brasso

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PURPOSE: The objective of this study was to investigate nationwide survival outcomes in men with localized prostate cancer managed on active surveillance. MATERIALS AND METHODS: A total of 936 men with localized prostate cancer were initiated on active surveillance in Denmark in 2002 to 2012. Kaplan-Meier estimated curative treatment-free, hormonal therapy-free, castration resistant prostate cancer-free and cause specific survival was calculated. RESULTS: Prostate cancer was classified as very low risk in 223 men, low risk in 436, intermediate risk in 259 (87% were at favorable intermediate risk) and high risk in 18. Median followup was 7.5 years (IQR 6.1-9.1). Kaplan-Meier estimated 10-year curative treatment-free survival was 62.8% (95% CI 59.1-66.3), 10-year hormonal therapy-free survival was 92.2% (95% CI 89.2-94.4), 10-year castration resistant prostate cancer-free survival was 97.2% (95% CI 95.3-98.4) and 10-year cause specific survival was 99.6% (95% CI 98.6-99.9). Compared to men with low risk prostate cancer, those with intermediate risk prostate cancer had higher curative treatment-free survival (69% vs 56%, p = 0.008), lower hormonal therapy-free survival (88% vs 95%, p = 0.005) and similar castration resistant prostate cancer-free survival (95% vs 99%, p = 0.17). CONCLUSIONS: In this nationwide cohort 10-year cause specific survival was similar to that in prospective active surveillance cohorts. Our study supports the use of active surveillance in men with localized prostate cancer, including men with favorable intermediate risk characteristics.

OriginalsprogEngelsk
TidsskriftJournal of Urology
Vol/bind201
Udgave nummer3
Sider (fra-til)520-527
ISSN0022-5347
DOI
StatusUdgivet - mar. 2019

Fingeraftryk

Prostatic Neoplasms
Denmark

Citer dette

Thomsen, F. B., Jakobsen, H., Langkilde, N. C., Borre, M., Jakobsen, E. B., Frey, A., ... Brasso, K. (2019). Active surveillance for localized prostate cancer. Nationwide, observational study. Journal of Urology, 201(3), 520-527. https://doi.org/10.1016/j.juro.2018.09.045
Thomsen, Frederik B ; Jakobsen, Henrik ; Langkilde, Niels Christian ; Borre, Michael ; Jakobsen, Erik B ; Frey, Anders ; Lund, Lars ; Lunden, Dagmar ; Dahl, Claus ; Helgstrand, J Thomas ; Brasso, Klaus. / Active surveillance for localized prostate cancer. Nationwide, observational study. I: Journal of Urology. 2019 ; Bind 201, Nr. 3. s. 520-527.
@article{618081c93ffa49579911f704a08e6264,
title = "Active surveillance for localized prostate cancer. Nationwide, observational study",
abstract = "PURPOSE: The objective of this study was to investigate nationwide survival outcomes in men with localized prostate cancer managed on active surveillance. MATERIALS AND METHODS: A total of 936 men with localized prostate cancer were initiated on active surveillance in Denmark in 2002 to 2012. Kaplan-Meier estimated curative treatment-free, hormonal therapy-free, castration resistant prostate cancer-free and cause specific survival was calculated. RESULTS: Prostate cancer was classified as very low risk in 223 men, low risk in 436, intermediate risk in 259 (87{\%} were at favorable intermediate risk) and high risk in 18. Median followup was 7.5 years (IQR 6.1-9.1). Kaplan-Meier estimated 10-year curative treatment-free survival was 62.8{\%} (95{\%} CI 59.1-66.3), 10-year hormonal therapy-free survival was 92.2{\%} (95{\%} CI 89.2-94.4), 10-year castration resistant prostate cancer-free survival was 97.2{\%} (95{\%} CI 95.3-98.4) and 10-year cause specific survival was 99.6{\%} (95{\%} CI 98.6-99.9). Compared to men with low risk prostate cancer, those with intermediate risk prostate cancer had higher curative treatment-free survival (69{\%} vs 56{\%}, p = 0.008), lower hormonal therapy-free survival (88{\%} vs 95{\%}, p = 0.005) and similar castration resistant prostate cancer-free survival (95{\%} vs 99{\%}, p = 0.17). CONCLUSIONS: In this nationwide cohort 10-year cause specific survival was similar to that in prospective active surveillance cohorts. Our study supports the use of active surveillance in men with localized prostate cancer, including men with favorable intermediate risk characteristics.",
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author = "Thomsen, {Frederik B} and Henrik Jakobsen and Langkilde, {Niels Christian} and Michael Borre and Jakobsen, {Erik B} and Anders Frey and Lars Lund and Dagmar Lunden and Claus Dahl and Helgstrand, {J Thomas} and Klaus Brasso",
note = "Copyright {\circledC} 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.",
year = "2019",
month = "3",
doi = "10.1016/j.juro.2018.09.045",
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Thomsen, FB, Jakobsen, H, Langkilde, NC, Borre, M, Jakobsen, EB, Frey, A, Lund, L, Lunden, D, Dahl, C, Helgstrand, JT & Brasso, K 2019, 'Active surveillance for localized prostate cancer. Nationwide, observational study', Journal of Urology, bind 201, nr. 3, s. 520-527. https://doi.org/10.1016/j.juro.2018.09.045

Active surveillance for localized prostate cancer. Nationwide, observational study. / Thomsen, Frederik B; Jakobsen, Henrik; Langkilde, Niels Christian; Borre, Michael; Jakobsen, Erik B; Frey, Anders; Lund, Lars; Lunden, Dagmar; Dahl, Claus; Helgstrand, J Thomas; Brasso, Klaus.

I: Journal of Urology, Bind 201, Nr. 3, 03.2019, s. 520-527.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Active surveillance for localized prostate cancer. Nationwide, observational study

AU - Thomsen, Frederik B

AU - Jakobsen, Henrik

AU - Langkilde, Niels Christian

AU - Borre, Michael

AU - Jakobsen, Erik B

AU - Frey, Anders

AU - Lund, Lars

AU - Lunden, Dagmar

AU - Dahl, Claus

AU - Helgstrand, J Thomas

AU - Brasso, Klaus

N1 - Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

PY - 2019/3

Y1 - 2019/3

N2 - PURPOSE: The objective of this study was to investigate nationwide survival outcomes in men with localized prostate cancer managed on active surveillance. MATERIALS AND METHODS: A total of 936 men with localized prostate cancer were initiated on active surveillance in Denmark in 2002 to 2012. Kaplan-Meier estimated curative treatment-free, hormonal therapy-free, castration resistant prostate cancer-free and cause specific survival was calculated. RESULTS: Prostate cancer was classified as very low risk in 223 men, low risk in 436, intermediate risk in 259 (87% were at favorable intermediate risk) and high risk in 18. Median followup was 7.5 years (IQR 6.1-9.1). Kaplan-Meier estimated 10-year curative treatment-free survival was 62.8% (95% CI 59.1-66.3), 10-year hormonal therapy-free survival was 92.2% (95% CI 89.2-94.4), 10-year castration resistant prostate cancer-free survival was 97.2% (95% CI 95.3-98.4) and 10-year cause specific survival was 99.6% (95% CI 98.6-99.9). Compared to men with low risk prostate cancer, those with intermediate risk prostate cancer had higher curative treatment-free survival (69% vs 56%, p = 0.008), lower hormonal therapy-free survival (88% vs 95%, p = 0.005) and similar castration resistant prostate cancer-free survival (95% vs 99%, p = 0.17). CONCLUSIONS: In this nationwide cohort 10-year cause specific survival was similar to that in prospective active surveillance cohorts. Our study supports the use of active surveillance in men with localized prostate cancer, including men with favorable intermediate risk characteristics.

AB - PURPOSE: The objective of this study was to investigate nationwide survival outcomes in men with localized prostate cancer managed on active surveillance. MATERIALS AND METHODS: A total of 936 men with localized prostate cancer were initiated on active surveillance in Denmark in 2002 to 2012. Kaplan-Meier estimated curative treatment-free, hormonal therapy-free, castration resistant prostate cancer-free and cause specific survival was calculated. RESULTS: Prostate cancer was classified as very low risk in 223 men, low risk in 436, intermediate risk in 259 (87% were at favorable intermediate risk) and high risk in 18. Median followup was 7.5 years (IQR 6.1-9.1). Kaplan-Meier estimated 10-year curative treatment-free survival was 62.8% (95% CI 59.1-66.3), 10-year hormonal therapy-free survival was 92.2% (95% CI 89.2-94.4), 10-year castration resistant prostate cancer-free survival was 97.2% (95% CI 95.3-98.4) and 10-year cause specific survival was 99.6% (95% CI 98.6-99.9). Compared to men with low risk prostate cancer, those with intermediate risk prostate cancer had higher curative treatment-free survival (69% vs 56%, p = 0.008), lower hormonal therapy-free survival (88% vs 95%, p = 0.005) and similar castration resistant prostate cancer-free survival (95% vs 99%, p = 0.17). CONCLUSIONS: In this nationwide cohort 10-year cause specific survival was similar to that in prospective active surveillance cohorts. Our study supports the use of active surveillance in men with localized prostate cancer, including men with favorable intermediate risk characteristics.

KW - Denmark

KW - mortality

KW - prostatic neoplasms

KW - risk

KW - watchful waiting

U2 - 10.1016/j.juro.2018.09.045

DO - 10.1016/j.juro.2018.09.045

M3 - Journal article

VL - 201

SP - 520

EP - 527

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

IS - 3

ER -