Conservative Management in Prostate Cancer Feasible

Older men with localized disease have favorable 10-year prostate cancer-specific outcomes

20 sept 2009-- In older men with localized prostate cancer, conservative management is associated with significantly improved 10-year outcomes compared to earlier eras, according to a study published in the Sept. 16 issue of the Journal of the American Medical Association.

Grace L. Lu-Yao, Ph.D., of the Cancer Institute of New Jersey in New Brunswick, and colleagues studied outcomes in 14,516 men ages 65 years or older who were diagnosed with stage T1 or T2 prostate cancer between 1992 and 2002 and managed without surgery or radiation for six months after diagnosis.

In men who were diagnosed at a median age of 78 years, the researchers found that 10-year prostate cancer-specific mortality rates associated with well, moderate, and poorly differentiated tumors were 8.3, 9.1, and 25.6 percent, respectively, and that the corresponding 10-year risks of dying from competing causes were nearly 60 percent. In men who were diagnosed between ages 66 and 74 years with moderately differentiated tumors, they found that the 10-year prostate cancer-specific mortality rate was 60 to 74 percent lower than the 6 percent rate observed in earlier 1992 to 2002 studies compared to the 15 to 23-percent rates observed in the pre-PSA era (1949 to 1992).

"Considering favorable 10-year outcomes following conservative management, men with a life expectancy of less than 10 years may wish to consider an active surveillance or watchful waiting protocol as an alternative to immediate attempted curative therapy," the authors conclude.

Abstract
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