Active Surveillance for Localized Prostate Cancer by Laurence Klotz

Author:Laurence Klotz
Language: eng
Format: epub
Publisher: Humana Press, Totowa, NJ

A comparison of prostate cancer mortality among men treated conservatively demonstrated that for stage T1 disease, this has diminished over the last 20 years from 16–23% to 2–5% [18].

The PSA progression rate among the 125 patients offered definitive local therapy is 53% at five years. There was no significant difference between patients treated with surgery or radiation.

We believe this PSA failure rate should be interpreted in the following context: (a)Among the “stable” cohort of untreated patients, none have progressed clinically, either to metastatic locally advanced disease. Thus, the appropriate denominator for PSA failure is the 450 patients in the total cohort. Therefore, the real PSA failure rate in the cohort is 59/450, or 13%. This is comparable to PSA failure rates for radical prostatectomy or radiation for favorable-risk patients.

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