As per findings from a prospective multicenter study, most men having clinically localized prostate cancer stayed on active surveillance for five years without disease reclassification or adverse pathology at surgery.

The Canary Prostate cancer Active Surveillance Study (PASS) opened for enrollment in 2008, in response to increasing proof of the overtreatment of prostate cancer. The aim of the study is to identify biomarkers for prostate cancer outcomes.

Daniel W. Lin, MD, professor and chief of urologic oncology at University of Washington in Seattle, along with colleagues carried out the first analysis of clinical factors linked to outcomes of 905 men (median age, 63 years), who were enrolled in the study. They found that, at diagnosis, 87% of the men met National Comprehensive Cancer Network criteria for very low risk or low risk cancer.

They set 28 months (interquartile range, 33.5 months) as the median follow-up from diagnosis and during that time, 24% of the patients had experienced tumor grade and/or volume reclassification. In that group, 53% were started given treatment whereas 31% stayed on active surveillance. 10 years was the median time free of treatment.

As a whole, ultimately, 19% of the patients received treatment, out of which 68% did so due to having an adverse reclassification. Rest 32% chose treatment without disease reclassification.

Findings of a multivariable analyses found that adverse reclassification seemed linked to the percentage of biopsy cores with cancer (P = .01), BMI (P = .04) and PSA density (P = .04).