Intermediate-Term Outcomes for Men with Very Low/Low and Intermediate/High Risk Prostate Cancer Managed by Active Surveillance

Yaw A. Nyame, Nima Almassi, Samuel C. Haywood, Daniel J. Greene, Vishnu Ganesan, Charles Dai, Joseph Zabell, Chad Reichard, Hans Arora, Anna Zampini, Alice Crane, Daniel Hettel, Ahmed Elshafei, Khaled Fareed, Robert J. Stein, Ryan K. Berglund, Michael Gong, J. Stephen Jones, Eric A. Klein, Andrew J. Stephenson

Research output: Contribution to journalArticlepeer-review

34 Scopus citations


Purpose We compare intermediate term clinical outcomes among men with favorable risk and intermediate/high risk prostate cancer managed by active surveillance. Materials and Methods A total of 635 men with localized prostate cancer have been on active surveillance since 2002 at a high volume academic hospital in the United States. Median followup is 50.5 months (IQR 31.1–80.3). Time to event analysis was performed for our clinical end points. Results Of the cohort 117 men (18.4%) had intermediate/high risk disease. Overall 5 and 10-year all cause survival was 98% and 94%, respectively. Cumulative metastasis-free survival at 5 and 10 years was 99% and 98%, respectively. To date no cancer specific deaths had been observed. Overall freedom from intervention was 61% and 49% at 5 and 10 years, respectively. Overall cumulative freedom from failure of active surveillance, defined as metastasis or biochemical failure after local therapy with curative intent, was 97% and 91% at 5 and 10 years, respectively. Of the men 21 (9.9%) experienced biochemical failure after deferred treatment and the 5-year progression-free probability was 92%. Compared to men with favorable risk disease those with intermediate/high risk cancer experienced no difference in metastases, surveillance failure or curative intervention. However, patients at higher risk were at significantly increased risk for all cause mortality, likely reflecting patient selection factors. These conclusions may be limited by the small number of events and the duration of our study. Conclusions Patients with localized prostate cancer who are on active surveillance demonstrated a low rate of active surveillance failure, prostate cancer specific mortality and metastases regardless of baseline risk.

Original languageEnglish (US)
Pages (from-to)591-599
Number of pages9
JournalJournal of Urology
Issue number3
StatePublished - Sep 2017


  • epidemiology
  • mortality
  • prostatic neoplasms
  • risk factors
  • sentinel surveillance


Dive into the research topics of 'Intermediate-Term Outcomes for Men with Very Low/Low and Intermediate/High Risk Prostate Cancer Managed by Active Surveillance'. Together they form a unique fingerprint.

Cite this