Active surveillance is a standard method of care for individuals with low-risk prostate cancer. However, this method needs repeated assessments, antigen tests, and biopsies, leading to increased complications, anxiety, and cost of treatment. This study aims to use active surveillance to identify high-risk candidates so that they can defer the rest from the method.

The data was collected from the PASS (prostate active surveillance study). This included individuals from 9 different N. American medical centers. After the search, 850 men with the required criteria were found. The exclusion criteria included any form of treatment within six months from cancer diagnosis, diagnosed before 2003, and grade 2 in the Gleason grade score during diagnosis, lack of surveillance biopsy, or missing information.

Out of 850, 774 were between 58 and 68 years old. The hazard ratio (HR) for those who had a negative biopsy history was 0.52. The increase in the time since the diagnosis imposes 1.62 HR. Those with higher BMI had 1.08 HR. Individuals with larger prostate size had 0.4 HR, and those with prostate-specific antigen during diagnosis had 1.51 HR.  The prediction analysis results showed a negative value (0.88) for the men at the lower 25 percentile and negative 0.95 for those in the lower ten percentile.

This study calculated seven parameters that can be used to classify the individuals as low or high-risk cases. Low-risk individuals can be included in any less intensive regime for maintenance.

Ref URL: https://jamanetwork.com/journals/jamaoncology/article-abstract/2769893