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“Watchful Waiting and Factors Predictive of Secondary Treatment of Localized Prostate Cancer”
WU, HONGYAN; SUN, LEON; MOUL, JUDD W.; WU, HONGYU; McLEOD, DAVID G.; AMLING, CHRISTOPHER; LANCE, RAYMOND; KUSUDA, LEO; DONAHUE, TIMOTHY; FOLEY, JOHN; CHUNG, ANDREW; SEXTON, WADE; SODERDAHL, DOUGLAS Journal of Urology. 171(3):1111-1116, March 2004
For some patients with localized prostate cancer, watchful waiting remains a viable treatment option. Doctors in this study evaluated demographic, clinical, and outcome characteristics of patients choosing this treatment as an initial strategy. Throughout the study they were able to determine certain factors that may predict an eventual development to secondary treatment. From 1990 to 2001, 8,390 patients were diagnosed with prostate cancer, out of which 1,158 patients choose to begin with watchful waiting. Of the 1,158 patients, most were older, had a lower PSA level at diagnosis, and were more likely to have lower stage and lower grade cancers than patients who had chosen more aggressive treatment options. Doctors discovered that age, PSA, and clinical stage were all significant factors in the prediction of whether or not secondary treatment is needed.
“Time Trends and Characteristics of Men Choosing Watchful Waiting for Initial Treatment of Localized Prostate Cancer”
HARLAN, SUSAN R.; COOPERBERG, MATTHEW R.; ELKIN, ERIC P. +; LUBECK, DEBORAH P.; MENG, MAXWELL V.; MEHTA, SHILPA S.; CARROLL, PETER R. Journal of Urology. 170(5):1804-1807, November 2003.
In this study 402 patients from The Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE) chose watchful waiting as their initial treatment between 1989 and 2000. Doctors examined patients at 3-year intervals. The use of watchful waiting increased from 7.5% in 1989 to 1991 to 9.5% in 1992 to 1994 and then decreased during the next 6 years to 5.5% in 1998 to 2000. As time progressed there was an increase in watchful waiting patients with T1 cancer and a PSA of 10 or less. Also they were generally around 75 years old at the time of treatment with Medicare insurance.
“Prostate Cancer Characteristics and Prostate Specific Antigen Changes in Screening Detected Patients Initially Treated with a Watchful Waiting Policy”
de VRIES, STIJN H.; RAAIJMAKERS, RENE; KRANSE, RIES; BLIJENBERG, BERT G.; SCHRODER, F H. Journal of Urology. 172(6, Part 1 of 2):2193-2196, December 2004.
Patients in this analysis were chosen from The European Randomized Study of Screening for Prostate Cancer and had proven prostate cancer and a PSA less than 10ng/mL. One hundred and ninety one patients chose watchful waiting based on their own personal desire or the advice from their physician. Patients were generally around 69 years old and 92.6% had a Gleason score of approximately 3 or lower. After 12 months 133 patients were included in the follow-up. Of 133, 35 patients (29.2%) had a negative PSA slope. There were 30 patients who decided to alter their treatment during the follow-up period. In order to validate these results further follow-up is needed.
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