CREMONA – In men who receive a diagnosis of prostate cancer localized, active monitoring can be a valid alternative to a therapeutic intervention. A study presented at the congress of the European Association of Urology ongoing in Milan and published simultaneously on New England Journal of Medicine shows in fact that, in these patients, active monitoring guarantees 15-year survival rates of approximately 97%, comparable to those of radiotherapy and surgery. The research looked at 1,643 men diagnosed with localized prostate cancer, divided into three groups: 545 assigned to undergo active monitoring, 553 to prostatectomy, and 545 to radiotherapy.
After 15 years of observation, the researchers have found a prostate cancer mortality of 3.1% in the active monitoring group, 2.2% in those who had undergone prostatectomy, 2.9% in those who had received radiotherapy. Although monitoring guaranteed the same survival sparing the side effects of other treatments, it is not without its disadvantages: the patients who remained under observation had a higher risk of developing metastases (9.4% against 4.7% of those had received the surgery and 5% of whom had radio done). The risk of clinical progression of the disease is also higher.
In addition, approximately 2 of 3 patients monitored over the 15 years still required surgery or radiation therapy. “When making decisions about how to manage their disease, men with newly diagnosed localized prostate cancer and their doctors can take the time to carefully weigh the relationship between harms and benefits of treatments», conclude the researchers, according to which it is still essential to develop more reliable strategies to distinguish the more aggressive prostate tumors from the less dangerous ones. (HANDLE)
