Post-Treatment surveillance intensity and overall survival in prostate cancer survivors (AFT-30)
Menée à partir de données portant sur 10 147 patients ayant survécu à un cancer localisé de la prostate diagnostiqué entre 2005 et 2010 (durée de suivi : supérieure à 8 ans), cette étude analyse l'association entre l'intensité d'une surveillance après traitement (prostatectomie radicale ou radiothérapie), définie par le nombre de tests de PSA réalisés au cours de la première année, et la survie globale
Résumé en anglais
Post-treatment surveillance affects millions of cancer survivors, but empiric data to guide clinical practice is lacking. This study assessed whether the intensity of surveillance testing after radical prostatectomy (RP) or radiation therapy (RT) for localized prostate cancer is associated with overall survival.Men diagnosed with localized prostate cancer between 2005 and 2010 who underwent RP or RT at a Commission on Cancer-accredited facility were randomly sampled. Primary data collected of 10,147 patients sampled across 1007 facilities were linked with existing data from the National Cancer Database. Analysis examined whether intensity of surveillance measured as the number of PSA tests in the first year after primary treatment [categorized as 0-1 (low intensity), 2 (medium) or ≥ 3 (high intensity) PSA tests] was associated with overall survival. Secondary outcomes included recurrence-free survival (RFS) and subsequent use of imaging tests, biopsy procedures, and salvage treatment.Median follow-up exceeded 8 years from prostate cancer diagnosis. OS was not statistically significantly different across surveillance intensity groups among RT (P = .59) or RP (P = .29) patients. RFS was not statistically significantly different across surveillance intensity groups for RT (P = .13) patients, but was for RP (P = .01) patients with high intensity associated with the worse RFS. In both treatments, higher surveillance intensity was associated with more procedures and salvage treatments.In patients with localized prostate cancer, more frequent PSA surveillance testing after radical prostatectomy or radiation therapy was associated with increased procedures and salvage treatments but not overall survival.
