In review of five patients, only one with favorable disease had theoretically preventable death

-- Jeff Muise

Friday, June 25, 2010 (Last Updated: 06/29/2010)

FRIDAY, June 25 (HealthDay News) -- Active surveillance appears to be a sound approach to managing prostate cancer with a favorable risk profile, according to a review published in the July issue of The Journal of Urology.

Yonah Krakowsky, of the University of Toronto, and colleagues reviewed the results of a study of active surveillance in 453 prostate cancer patients with favorable risk profiles. The researchers examined the cases of five patients in the surveillance program who progressed to metastatic disease and died to determine if any of the deaths were preventable.

Upon review, the investigators found one patient to be at intermediate risk at the start of surveillance, and another's risk was upgraded within a year. All the patients exhibited a prostate-specific antigen doubling time of 1.6 years or less, prompting radiation (two patients) or radical prostatectomy (one patient). However, one patient was lost to follow-up and another chose androgen deprivation therapy over radical therapy. Only one patient presented with favorable risk, was treated in accordance with surveillance parameters, but ultimately died.

"Only one of the five patients presented with favorable disease and experienced a theoretically preventable death. The absence of preventable deaths suggests that the basic approach is sound. Two patients had a trigger for intervention but did not receive it. This reinforces the importance of close monitoring and of definitive treatment for those in whom disease is reclassified as higher risk over time," the authors write.

Abstract
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Specialties Hematology & Oncology
Urology
Internal Medicine
Family Practice

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