Real World Evidence of Active Surveillance for Prostate Cancer in Spain; Midterm Results

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Publicat a:	Cancer Medicine vol. 14, no. 17 (Sep 1, 2025)
Autor principal:	Rubio‐Briones, J.
Altres autors:	Borque‐Fernando, A., Esteban Escaño, L. M., Wong, A., Guijarro Cascales, A., Gómez Gómez, E., Gil Fabra, J. M., Sanguedolce, F., Gomez‐Veiga, F., López González, P. A., Plata Bello, A., Rodríguez García, N., Montesino Semper, M., Suárez Novo, J. F., Hajianfar, R., Fumadó Ciutat, L. l., González Alfaro, A., Duarte Ojeda, J. M., Bono Ariño, A., Quicios Dorado, C., Loizaga Iriarte, A., García Fadrique, G., Giménez Bachs, J. M., García Barreras, S., Pallas Costa, Y., Vilaseca Cabo, A., Rodrigo Aliaga, M., Campanario Pérez, F., Servián, P., Campá Bortoló, J. M., Soto Delgado, M., Rodríguez de Ledesma, J. M., Sánchez Rodríguez, C., Chantada Abal, V., Hernández Martínez, Y. E., Herrera Imbroda, B., Dolezal, P., Gual Frau, J., Medrano Llorente, P., Moreno Jiménez, J., Serrano Uribe, J. S., Congregado Ruiz, C. B., Reyes, A., Fernández Aparicio, T., García Rodríguez, J., Cuadras Solé, M., García Seguí, A., Pacheco Bru, J. J., Mayor de Castro, J., Mira Moreno, A., Molina Suárez, J. L.
Publicat:	John Wiley & Sons, Inc.
Matèries:	Spain Patients Tomography Magnetic resonance imaging Metastasis Biopsy Costs Mortality Prostate cancer Surveillance Metastases Survival Risk groups Aging Ultrasonic imaging
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Resum:	ABSTRACT Patients and Methods In this multicenter longitudinal study, data from the Spanish Register in AS (AEU‐PIEM/2014/0001) were reviewed. The study focused on a cohort of AS patients registered between 2014 and 2019, featuring open inclusion criteria and diverse follow‐up strategies. Results A total of 3315 AS patients were recruited, with 2881 and 434 categorized into the low and intermediate risk groups based on NCCN grouping at inclusion. The median age was 67 years, and only 11% underwent diagnostic biopsy guided by MRI. The median time between follow‐up visits was 6.03 months. Over a median follow‐up of 62 months (Q1–3: 43.78–85.58), 37% remained in AS, while 8% transitioned to watchful waiting due to aging or intercurrent disease. Death occurred in 199 (6%) of patients, with 3 due to prostate cancer progression and 196 attributed to other causes. At 2 and 5 years, pathological progression‐free survival, metastasis‐free survival, and active treatment‐free survival were 68% and 51%, 99% and 99%, and 70% and 50%, respectively. Conclusions Midterm oncological outcomes of AS in Spain align with major international series. We denote underuse of guideline recommendations such as use of MRI or TP Bx for initial PCa characterization. Collaborative efforts are crucial in the search for algorithms, new imaging, or biomarkers to refine indications and transition to active treatments. Trial Registration ClinicalTrials.gov identifier: NCT02865330
ISSN:	2045-7634
DOI:	10.1002/cam4.71173
Font:	Health & Medical Collection