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Treatment of intermediate-risk prostate cancer with active surveillance in the routine care—Long-term outcomes of a prospective noninterventional study(HAROW)

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Current Urology 2024年第2期18卷 115-121页

作者： Lothar Weissbach Andreas Schwarte Edith A.Boedefeld Jan Herden Health Research for Men GmbH BerlinGermany urological practice borken BorkenGermany Department of Urology Uro-OncologyRobot-Assisted and Reconstructive UrologyFaculty of Medicine and University Hospital CologneUniversity of CologneCologneGermany PAN Clinic Urological practiceCologneGermany

Background:We report here the long-term outcomes of patients with intermediate-risk prostate cancer(PCa)treated with active surveillance(AS)in a daily routine *** andmethods:HAROW(2008–2013)was a noninterventional,health service research study investigating themanagement of localized PCa in a community setting.A substantial proportion of the study centers were office-based urologists.A follow-up examination of all intermediate-risk patients with AS was ***,cancer-specific,metastasis-free,and treatment-free survival rates,as well as reasons for discontinuation,were determined and ***:Of the 2957 patients enrolled,52 with intermediate-risk PCa were managed with AS and were available for *** median follow-up was 6.8 years(interquartile range,3.4–8.6 years).Seven patients(13.5%)died of causes unrelated to PCa,of whom 4 were under AS or under watchful *** patients(3.8%)developed *** estimated 8-year overall,cancer-specific,metastasis-free,and treatment-free survival rates were 85%(95%confidence interval[CI],72%–96%),100%,93%(95%CI,82%–100%),and 31%(95%CI,17%–45%),*** analysis,prostate-specific antigen density of≥0.2 ng/mL2 was significantly predictive of receiving invasive treatment(hazard ratio,3.29;p=0.006).Reasons for discontinuation were more often due to patient's or physician's concerns(36%)than due to observed clinical ***:Although survival outcome data for intermediate-risk patients managed with AS in real-life health care conditions were promising,rates of discontinuation were high,and discontinuation was often a patient's decision,even when the signs of disease progression were *** might be an indication of higher levels of mental burden and anxiety in this specific subgroup of patients,which should be considered when making treatment *** a psychological perspective,not all intermediate-risk patients are optimal candidates for A

关键词： Active surveillance Intermediate-risk prostate cancer HAROW study Conservative management Outcomes research

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