Re: Active Surveillance results at s Hopkins

[Guest guest]

"Curative intent"

That's a thought provoking phrase. Isn't that every ones goal?

To: ProstateCancerSupport <ProstateCancerSupport >Sent: Wed, April 27, 2011 12:47:28 PMSubject: Active Surveillance results at s Hopkins

s Hopkins recently published the results of 769 men in their Active Surveillance program, going back to 1995. Authors of the paper included A.W. Partin, author of the "Partin Tables", and Walsh, noted prostate surgeon and co-developer of the PSA test.

Their conclusion, "For carefully selected men, active surveillance with curative intent appears to be a safe alternative to immediate intervention. Limiting surveillance to very-low-risk patients may reduce the frequency of adverse outcomes."

http://www.ncbi.nlm.nih.gov/pubmed/21464416?s_cid=pubmed

The abstract is below.

The Best to You and Yours!Jon in Nevada===========================================================Active Surveillance Program for Prostate Cancer: An Update of the s Hopkins Experience.J Clin Oncol. 2011 Apr 4. [Epub ahead of print]

Tosoian JJ, Trock BJ, Landis P, Feng Z, Epstein JI, Partin AW, Walsh PC, HB.The s Hopkins University School of Medicine, The Buchanan Brady Urological Institute, and s Hopkins Hospital, Baltimore, MD.

AbstractPURPOSE We assessed outcomes of men with prostate cancer enrolled in active surveillance.

PATIENTS AND METHODS Since 1995, a total of 769 men diagnosed with prostate cancer have been followed prospectively (median follow-up, 2.7 years; range, 0.01 to 15.0 years) on active surveillance. Enrollment criteria were for very-low-risk cancers, defined by clinical stage (T1c), prostate-specific antigen density < 0.15 ng/mL, and prostate biopsy findings (Gleason score = 6, two or fewer cores with cancer, and = 50% cancer involvement of any core). Curative intervention was recommended on disease reclassification on the basis of biopsy criteria. The primary outcome was survival free of intervention, and secondary outcomes were rates of disease reclassification and exit from the program. Outcomes were compared between men who did and did not meet very-low-risk criteria.

RESULTS The median survival free of intervention was 6.5 years (range, 0.0 to 15.0 years) after diagnosis, and the proportions of men remaining free of intervention after 2, 5, and 10 years of follow-up were 81%, 59%, and 41%, respectively. Overall, 255 men (33.2%) underwent intervention at a median of 2.2 years (range, 0.6 to 10.2 years) after diagnosis; 188 men (73.7%) underwent intervention on the basis of disease reclassification on biopsy. The proportions of men who underwent curative intervention (P = .026) or had biopsy reclassification (P < .001) were significantly lower in men who met enrollment criteria than in those who did not. There were no prostate cancer deaths.

CONCLUSION For carefully selected men, active surveillance with curative intent appears to be a safe alternative to immediate intervention. Limiting surveillance to very-low-risk patients may reduce the frequency of adverse outcomes.

PMID: 21464416