@article{Richard_Timilshina_Komisarenko_Martin_Ahmad_Alibhai_Hamilton_Kulkarni_Finelli_2020, title={The long-term outcomes of Gleason grade groups 2 and 3 prostate cancer managed by active surveillance: Results from a large, population-based cohort}, volume={14}, url={https://cuaj.ca/index.php/journal/article/view/6328}, DOI={10.5489/cuaj.6328}, abstractNote={<p><strong>Introduction:</strong> Active surveillance (AS) is an accepted management strategy for low-risk prostate cancer (PCa), but its role in the management of favorable intermediate-risk PCa remains controversial. Most reports studying the role of AS for these men generally lack long-term followup and include small numbers of patients. Our objective was to report the outcomes of men diagnosed with Gleason grade groups (GGG) 2 and 3 PCa who were managed expectantly.</p> <p><strong>Methods:</strong> Using administrative datasets and pathology reports, we identified all men who were diagnosed with GGG 2 and 3 PCa and managed expectantly between 2002 and 2011 in Ontario, Canada. Outcomes and associated factors were estimated using cumulative incidence function methods and multivariable Cox regression models, respectively.</p> <p><strong>Results:</strong> We identified 926 men who were managed expectantly (AS [n=374] or watchful waiting [n=552]). The eight-year cancer-specific survival was 94% and 89% for the AS and watchful waiting cohorts, respectively. Among AS men, 266 (71%) received treatment after a followup of approximately eight years. Cumulative AS discontinuation rates at one and five years were 30.5% and 65.1%, respectively.</p> <p><strong>Conclusions:</strong> Expectant management of GGG 2 and 3 PCa may be an option for certain men. Notably for AS patients, the cancer-specific mortality at eight years was 6%, and over 65% of men underwent treatment within five years. Further studies are required to evaluate which patients, based on disease-specific features and competing health risks, would benefit most from a conservative strategy.</p>}, number={6}, journal={Canadian Urological Association Journal}, author={Richard, Patrick O. and Timilshina, Narhari and Komisarenko, Maria and Martin, Lisa and Ahmad, Ardalan and Alibhai, Shabbir M.H. and Hamilton, Robert J. and Kulkarni, Girish and Finelli, Antonio}, year={2020}, month={Jan.}, pages={174–81} }