Exploring the Long-term Outcomes of Active Surveillance Among Men With Prostate Cancer—Best for Whom?
Menée en Suède à partir de données portant sur 23 655 patients atteints d'un cancer de la prostate et sous surveillance active (âge médian au diagnostic : 69 ans), cette étude de cohorte présente une estimation des décès par cancer et par autre cause
In an effort to investigate the long-term outcomes of active surveillance (AS) among men with prostate cancer (PC), Ventimiglia et al1 developed a simulation model with a 30-year follow-up trajectory for men with PC managed with AS. The data used to develop the model were retrieved from the Prostate Cancer data Base Sweden (PCBaSe) and covered a follow-up period from 1992 to 2014. Men aged 40 to 75 years at diagnosis of very low-risk, low-risk, or intermediate-risk PC according to modified National Comprehensive Cancer Network risk categorization, and who did not receive an active treatment, were identified, including a total of 23 655 men. The model was used to estimate PC-related and non–PC-related causes of death as well as the proportion of remaining life-years without active PC treatment until death or age 85 years. The proportions of men who died of PC before age 85 years were 9%, 13%, and 15% of men with very low-risk, low-risk, and intermediate-risk PC, respectively. The mean proportion of remaining life-years without active treatment of very low-risk, low-risk, and intermediate-risk PC was 48%, 36%, and 29%, respectively, for men diagnosed at 55 years of age compared with 77%, 66%, and 60%, respectively, for men diagnosed at 70 years of age. The findings suggest that among included patients, AS was a safe management approach for men above 65 years of age with low-risk PC.
JAMA Network Open , commentaire en libre accès, 2021