NS-AUA 2024 Annual Meeting Abstracts – Oncology – Prostate

Introduction: Active surveillance (AS) is widely accepted as a treatment pathway for low-risk and favorable intermediate-risk localized prostate cancer.We aimed to report the long-term progression of patients on AS to treatment.Methods: In a retrospective cohort study performed at a single institution center, 2521 men with low or favorable intermediate-risk prostate cancer were managed with an active surveillance protocol from 2000-2023.Main outcomes measured were overall survival and time to treatment.Results: Of the patients enrolled, 620 (24.6%) entered treatment, 395 (15.7%) patients died, 34 (1.3%) had metastasis, and six (17.6% of those with metastasis) died with metastasis.By race, 2337 (92.7%) were White, 143 (5.7%) African-American, 20 (0.8%) American Indian/Alaskan, 14 (0.6%) Asian, and seven (0.2%) other.Median followup was four years and maximum followup time was 22.2 years.Median age of patients was 73.8 with a range of 43.8 to 98.1 years.At five, 10, and 15 years, 71.3%, 62.7%, and 52% of patients remained untreated and on AS.For patients with Gleason score (GS) 3+3=6 on AS at five and 10 years, 81.4% and 76.3% remained untreated.Similarly, patients with GS 3+4=7 demonstrated 41.5% and 27.4% untreated rates.Conclusions: To our knowledge, we report the largest AS cohort examining time to treatment.AS for favorable-risk prostate cancer seems safe and effective in the 10-year timespan.In our study, 24.6% of patients progressed to treatment and 1.3% of patient developed metastasis.Additionally, 0.2% of patients on AS died with metastasis.