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Review
. 2023 Apr 6;12(7):2732.
doi: 10.3390/jcm12072732.

Comparison of Outcomes of Active Surveillance in Intermediate-Risk Versus Low-Risk Localised Prostate Cancer Patients: A Systematic Review and Meta-Analysis

Subhabrata Mukherjee  1 , Dimitrios Papadopoulos  1 , Joseph M Norris  2 , Mudassir Wani  3 , Sanjeev Madaan  4
Affiliations
Review

Comparison of Outcomes of Active Surveillance in Intermediate-Risk Versus Low-Risk Localised Prostate Cancer Patients: A Systematic Review and Meta-Analysis

Subhabrata Mukherjee et al. J Clin Med. .

Abstract

Currently, there is no clear consensus regarding the role of active surveillance (AS) in the management of intermediate-risk prostate cancer (IRPC) patients. We aim to analyse data from the available literature on the outcomes of AS in the management of IRPC patients and compare them with low-risk prostate cancer (LRPC) patients. A comprehensive literature search was performed, and relevant data were extracted. Our primary outcome was treatment-free survival, and secondary outcomes were metastasis-free survival, cancer-specific survival, and overall survival. The DerSimonian-Laird random-effects method was used for the meta-analysis. Out of 712 studies identified following an initial search, 25 studies were included in the systematic review. We found that both IRPC and LRPC patients had nearly similar 5, 10, and 15 year treatment-free survival rate, 5 and 10 year metastasis-free survival rate, and 5 year overall survival rate. However, cancer-specific survival rates at 5, 10, and 15 years were significantly lower in IRPC compared to LRPC group. Furthermore, IRPC patients had significantly inferior long-term overall survival rate (10 and 15 year) and metastasis-free survival rate (15 year) compared to LRPC patients. Both the clinicians and the patients can consider this information during the informed decision-making process before choosing AS.

Keywords: active monitoring; active surveillance; intermediate-risk prostate cancer; low-risk prostate cancer; prostate cancer.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram of study selection.
Figure 2
Figure 2
Definitive treatment (all studies) [11,25,26,28,29,30,31,35,38,39,40,41,42,45].
Figure 3
Figure 3
Treatment-free survival [11,14,15,25,26,28,31,36,37,39,40,41,44].
Figure 4
Figure 4
Metastasis-free survival [11,26,37,40,41,43].
Figure 5
Figure 5
Cancer-specifical survival [11,14,26,34,36,40,41].
Figure 6
Figure 6
Overall survival [11,26,31,34,36,40,41].
See this image and copyright information in PMC

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