Login to Access Video or Poster Abstract: MP43-19
Sources of Funding: none

Introduction

Active surveillance (AS) is a treatment option for favorable-risk prostate cancers (PCa). However, data concerning populations of African descent is missing. The objective of this study was to evaluate the safety and benefit of AS in an African Caribbean cohort with favorable-risk PCa.

Methods

Between 2005 and 2016, a monocentric prospective cohort study was conducted in Guadeloupe (French West Indies), including patients with low-risk PCa (prostate-specific antigen [PSA] ?10 ng/ml; Gleason ?6) or favorable intermediate-risk PCa (PSA, 10-20 ng/ml; Gleason ?7 (3+4); life expectancy <10 years) in AS. Treatment was recommended in case of histological progression, increase in tumor volume, PSA doubling time <36 months or patient’s wish. Outcomes were overall survival, disease-specific survival and duration of AS, calculated with the Kaplan-Meier method. Multivariate analysis was performed using the Cox proportional hazards model to identify predictors of AS termination.

Results

A total of 234 patients (median age 64 yr) were enrolled in the study. Median follow-up was 4 years (interquartile range: 2.3-5.5 yr). Overall survival at 30 months, 5 and 10 years was 99.5%, 98.5%, 90.7% respectively. Disease-specific survival at 30 months, 5 and 10 years was 100%. At 30 months, 5 and 10 years, 72.7%, 52.6%, 40.4% of patients respectively remained untreated and under AS. Age (hazard ratio [HR], 0.96 per additional year; 95% confidence interval [CI], 0.93-0.99) and PSA density (HR, 1.52 per additional 0.1; 95% CI, 1.20-1.89) were found to be independent predictors of AS termination.

Conclusions

AS seems to be safe and beneficial for African Caribbean men with favorable-risk PCa. The high rate of patients leaving AS may reflect a greater proportion of aggressive cancers in this population. PSA density could help to better select these patients. Longer follow-up is needed to confirm these results.

Funding

none