ArticleJournal of the National Comprehensive Cancer Network : JNCCN2022
Metastasis and Mortality in Men With Low- and Intermediate-Risk Prostate Cancer on Active Surveillance.
Article in Journal of the National Comprehensive Cancer Network : JNCCN, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 28 citations in OpenAlex.
- Survival and Mortality Predictors in Prostate Cancer: A Retrospective Cohort of 10 556 Brazilian Patients.Cancer reports (Hoboken, N.J.) · 2026Article
- A Deep Learning-Based Multimodal Clinico-Histology-Genomic Prognostic Model in Prostate Cancer.Annals of surgical oncology · 2026Article
- Factors Associated With Risk Stratification and Overall Survival of Black South African Men With Non-Metastatic Prostate Cancer.Cancer medicine · 2026Article
- Initial non-curative treatment for favorable intermediate-risk prostate cancer.International urology and nephrology · 2026Article
- Methylation-based signature to distinguish indolent and aggressive prostate cancer.Biology open · 2025Article
- Prognostic value of MR visibility/invisibility in men on Active Surveillance.Prostate cancer and prostatic diseases · 2025Article
- Active surveillance selection and 3-year durability in intermediate-risk prostate cancer following genomic testing.Prostate cancer and prostatic diseases · 2025Observational
- Appropriateness of Imaging for Low-Risk Prostate Cancer-Real World Data from the Pennsylvania Urologic Regional Collaboration (PURC).Current oncology (Toronto, Ont.) · 2024Article
- Identification of Genes with Rare Loss of Function Variants Associated with Aggressive Prostate Cancer and Survival.European urology oncology · 2024Article
- Evaluating Diagnostic Accuracy and Inter-reader Agreement of the Prostate Imaging After Focal Ablation Scoring System.European urology open science · 2024Article
- Expanding inclusion criteria for active surveillance in intermediate-risk prostate cancer: a machine learning approach.World journal of urology · 2023Article
- Comparison of Outcomes of Active Surveillance in Intermediate-Risk Versus Low-Risk Localised Prostate Cancer Patients: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2023Review
- Prognostic Value of the Intermediate-risk Feature in Men with Favorable Intermediate-risk Prostate Cancer: Implications for Active Surveillance.European urology open science · 2023Article
- Prospective Implementation and Early Outcomes of a Risk-stratified Prostate Cancer Active Surveillance Follow-up Protocol.European urology open science · 2023Article
- Active Surveillance in Intermediate-Risk Prostate Cancer: A Review of the Current Data.Cancers · 2022Review
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Authors and funding
14 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundActive surveillance (AS) is a safe treatment option for men with low-risk, localized prostate cancer. However, the safety of AS for patients with intermediate-risk prostate cancer remains unclear. PATIENTS AND
methodsWe identified men with NCCN-classified low-risk and favorable and unfavorable intermediate-risk prostate cancer diagnosed between 2001 and 2015 and initially managed with AS in the Veterans Health Administration. We analyzed progression to definitive treatment, metastasis, prostate cancer-specific mortality (PCSM), and all-cause mortality using cumulative incidences and multivariable competing-risks regression.
resultsThe cohort included 9,733 men, of whom 1,007 (10.3%) had intermediate-risk disease (773 [76.8%] favorable, 234 [23.2%] unfavorable), followed for a median of 7.6 years. The 10-year cumulative incidence of metastasis was significantly higher for patients with favorable (9.6%; 95% CI, 7.1%-12.5%; P<.001) and unfavorable intermediate-risk disease (19.2%; 95% CI, 13.4%-25.9%; P<.001) than for those with low-risk disease (1.5%; 95% CI, 1.2%-1.9%). The 10-year cumulative incidence of PCSM was also significantly higher for patients with favorable (3.7%; 95% CI, 2.3%-5.7%; P<.001) and unfavorable intermediate-risk disease (11.8%; 95% CI, 6.8%-18.4%; P<.001) than for those with low-risk disease (1.1%; 95% CI, 0.8%-1.4%). In multivariable competing-risks regression, favorable and unfavorable intermediate-risk patients had significantly increased risks of metastasis and PCSM compared with low-risk patients (all P<.001).
conclusionsCompared with low-risk patients, those with favorable and unfavorable intermediate-risk prostate cancer managed with AS are at increased risk of metastasis and PCSM. AS may be an appropriate option for carefully selected patients with favorable intermediate-risk prostate cancer, though identification of appropriate candidates and AS protocols should be tested in future prospective studies.
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