Presentation on Active Surveillance in Younger Men Wins Award

Submitted by Leslie Lingaas on March 3, 2016 at 8:28 am

Active surveillance is increasingly used as a management approach for men with low-risk prostate cancer, but until now, there has been little investigation regarding outcomes in younger patients who are often advised to receive treatment.

UCSF urologic oncology fellow Michael S. Leapman, MD, and colleagues won first prize at a recent international meeting for a poster presentation analyzing data from men followed at UCSF that confirmed active surveillance is appropriate for men of all ages with low-risk disease.   The conference, held in February in Milan, Italy, was sponsored by the European School of Oncology in collaboration with the European Association of Urology, and focused exclusively on active surveillance for prostate cancer.

The study is important because, while rates of utilization of surveillance have increased overall in the United States, these have largely been driven by conservative approaches in older patients. Little has been known, however, regarding the appropriateness of active surveillance among younger patients.

The research team analyzed outcomes for 1,443 men followed between 1995 and 2015 at UCSF with active surveillance consisting of periodic PSA monitoring, transrectal ultrasound and prostate biopsy.  Of these, 599 (42%) were age 60 or younger. The research found that, with an average of four years of surveillance, being 60 or younger was associated with a lower risk of disease progression as evidenced on biopsy. Rates of treatment for both groups were similar, indicating higher rates of treatment in the absence of disease progression, said Leapman.

“This is the largest and most comprehensive analysis of the role age plays in active surveillance in prostate cancer. It is crucial to emphasize that these findings are limited to the short term and that further investigation is warranted.  The take-away message, however, from this study is that younger patients with low clinical risk features exhibited comparatively favorable initial outcomes on active surveillance,” said Leapman.