Adverse Pathology Not Seen in Deferred Prostatectomy

Extent of disease not worsened in men who defer surgery for surveillance
By Lindsey Marcellin
HealthDay Reporter

FRIDAY, Sept. 24 (HealthDay News) -- Men with low- to intermediate-risk prostate cancer undergoing prostate-specific antigen surveillance who later have deferred radical prostatectomy do not have significantly worsened pathologic features after surgery than men undergoing primary radical prostatectomy, according to research published in the October issue of The Journal of Urology.

Benny Holmström, M.D., of Umeå University in Sweden, and colleagues reviewed data from the National Prostate Cancer Register of Sweden to assess differences in adverse pathology after surgery (upgrading of Gleason score, positive surgical margins, and extraprostatic extension) and prostate cancer-specific mortality in patients undergoing primary versus deferred radical prostatectomy.

The researches found that Gleason score upgrading occurred more frequently in surgical specimens from those who underwent deferred (38 percent) versus primary (25 percent) radical prostatectomy, but there were no statistically significant differences in positive surgical margins or extraprostatic extension. Overall, there was no difference in the percentage of men having any one or more of the three adverse pathologies. Prostate cancer-specific mortality rates did not significantly differ between the two groups at eight years (0.9 percent in the deferred group and 0.7 percent in the primary group).

"Our data show that large studies with a long follow-up are needed to conclusively evaluate surveillance and deferred curative treatment for localized low-risk prostate cancer," the authors write.

A co-author disclosed a financial relationship with AstraZeneca.

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