Active Surveillance Outperforms Treatment in Low-Risk Prostate Cancer Study

Khái niệm cốt lõi

Active surveillance is preferred over immediate treatment for low-risk prostate cancer patients, showing comparable outcomes.

Tóm tắt

Standalone Note here

• Most men with low-risk prostate cancer opt for active surveillance when provided detailed information on treatment options.
• A study in Italy aimed to promote active surveillance adoption and compare patient acceptance and outcomes with active treatment.
• 83% of men chose active surveillance over immediate treatment, with an increasing trend over time.
• Factors influencing the choice of active surveillance included age, comorbidity index, biopsy revision, and multidisciplinary assessment.
• Worse prognostic factors were associated with lower odds of choosing active surveillance.
• Overall survival was not worse for patients who chose active surveillance compared to those who chose radical treatment.
• The study highlighted the widespread adoption of active surveillance in the Regional Oncology Network.
• Key limitations included short follow-up, variability between centers, and a high rate of patients abandoning active surveillance.
• The study was published in JAMA Network Open and funded by various organizations.

Thống kê

Overall, 83% (706 of 852) men chose active surveillance over immediate treatment.
Patients aged 75 years or older were more likely to choose active surveillance (odds ratio [OR], 4.27).
Patients with a Charlson Comorbidity Index ≥2 were more likely to choose active surveillance (OR, 1.98).
Patients who underwent independent revision of the first biopsy were more likely to choose active surveillance (OR, 2.35).
Patients who underwent multidisciplinary assessment were more likely to choose active surveillance (OR, 2.65).
Patients with worse prognostic factors like stage T2a (OR, 0.54) and Gleason Score 3+4 (OR, 0.20) were less likely to choose active surveillance.

Trích dẫn

"The main remarkable finding of [the trial] is represented by the widespread adoption of active surveillance in our [Regional Oncology Network] since the beginning of the study, and the increasing trend over time, reaching approximately 90% of eligible patients in 2020 to 2021." - Authors

Thông tin chi tiết chính được chắt lọc từ

Active Surveillance Preferred in Low-Risk Prostate Cancer

by Megan Brooks lúc www.medscape.com 10-20-2023

https://www.medscape.com/viewarticle/997570

Yêu cầu sâu hơn

How does the adoption of active surveillance in Italy compare to other countries?

In Italy, the adoption of active surveillance for low-risk prostate cancer patients seems to be relatively high, with approximately 83% of men choosing this approach over immediate treatment. This rate is encouraging and suggests a positive trend towards embracing active surveillance as a preferred option. However, the adoption of active surveillance can vary significantly between countries due to various factors such as healthcare systems, cultural attitudes towards cancer treatment, and physician recommendations. Some countries may have higher rates of active treatment like radical prostatectomy or radiation therapy due to different medical practices or patient preferences. Overall, the adoption of active surveillance in Italy appears to be favorable compared to some other countries, but further research is needed to compare adoption rates globally.

What are the potential drawbacks of active surveillance for low-risk prostate cancer patients?

While active surveillance is a recommended approach for low-risk prostate cancer patients, there are potential drawbacks that need to be considered. One significant drawback is the psychological burden and anxiety that patients may experience due to living with the knowledge of having cancer and the uncertainty of disease progression. This constant monitoring and the fear of disease advancement can impact a patient's quality of life and mental well-being. Additionally, there is a risk of disease progression during active surveillance, leading to the need for eventual treatment, which can be challenging for patients who were initially hoping to avoid immediate intervention. Moreover, the high rate of patients abandoning active surveillance, often due to biochemical progression, highlights a limitation of this approach in effectively managing the disease in all cases. Therefore, careful patient selection, regular monitoring, and clear communication about the risks and benefits of active surveillance are essential to mitigate these drawbacks.

How can the high rate of patients abandoning active surveillance be addressed effectively?

To address the high rate of patients abandoning active surveillance for low-risk prostate cancer, several strategies can be implemented. Firstly, enhancing patient education and counseling about the rationale behind active surveillance, the expected course of the disease, and the importance of regular follow-up can help improve patient understanding and adherence to the protocol. Providing ongoing support and resources for patients undergoing active surveillance, including access to mental health services and support groups, can help alleviate anxiety and improve patient satisfaction with the chosen approach. Additionally, implementing structured programs for monitoring and managing patients on active surveillance, with clear guidelines for transitioning to treatment if necessary, can help reduce the rate of abandonment. Regular communication between healthcare providers and patients, as well as shared decision-making processes, can also play a crucial role in ensuring patient engagement and compliance with active surveillance protocols. By addressing these factors comprehensively, healthcare providers can work towards reducing the rate of patients abandoning active surveillance and improving the overall management of low-risk prostate cancer.