Skip to main content

Temporarily deferred therapy (watchful waiting) for men younger than 70 years and with low-risk localized prostate cancer in the prostate-specific antigen era.

Publication ,  Journal Article
Carter, CA; Donahue, T; Sun, L; Wu, H; McLeod, DG; Amling, C; Lance, R; Foley, J; Sexton, W; Kusuda, L; Chung, A; Soderdahl, D; Jackmaan, S; Moul, JW
Published in: J Clin Oncol
November 1, 2003

PURPOSE: Watchful waiting (WW) is an acceptable strategy for managing prostate cancer (PC) in older men. Prostate-specific antigen (PSA) testing has resulted in a stage migration, with diagnoses made in younger men. An analysis of the Department of Defense Center for Prostate Disease Research Database was undertaken to document younger men with low- or intermediate-grade PC who initially chose WW. PATIENTS AND METHODS: We identified men choosing WW who were diagnosed between January 1991 and January 2002, were 70 years or younger, had a Gleason score < or = 6 with no Gleason pattern 4, had no more than three positive cores on biopsy, and whose clinical stage was < or = T2 and PSA level was < or = 20. We analyzed their likelihood of remaining on WW, the factors associated with secondary treatment, and the influence of comorbidities. RESULTS: Three hundred thirteen men were identified. Median follow-up time was 3.8 years. Median age was 65.4 years (range, 41 to 70 years). Ninety-eight patients remained on WW; 215 proceeded to treatment. A total of 57.3% and 73.2% chose treatment within the first 2 and 4 years, respectively. Median PSA doubling time (DT) was 2.5 years for those who underwent therapy; those remaining on WW had a median DT of 25.8 years. The type of secondary treatment was associated with the number of patient's comorbidities (P =.012). CONCLUSION: Younger patients who choose WW seemed more likely to receive secondary treatment than older patients. PSA DTs often predict the use of secondary treatment. The number of comorbidities a patient has influences the type of secondary therapy chosen. The WW strategy may better be termed temporarily deferred therapy.

Duke Scholars

Published In

J Clin Oncol

DOI

ISSN

0732-183X

Publication Date

November 1, 2003

Volume

21

Issue

21

Start / End Page

4001 / 4008

Location

United States

Related Subject Headings

  • United States
  • Prostatic Neoplasms
  • Prostate-Specific Antigen
  • Proportional Hazards Models
  • Practice Patterns, Physicians'
  • Oncology & Carcinogenesis
  • Observation
  • Neoplasm Staging
  • Middle Aged
  • Medical Records
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Carter, C. A., Donahue, T., Sun, L., Wu, H., McLeod, D. G., Amling, C., … Moul, J. W. (2003). Temporarily deferred therapy (watchful waiting) for men younger than 70 years and with low-risk localized prostate cancer in the prostate-specific antigen era. J Clin Oncol, 21(21), 4001–4008. https://doi.org/10.1200/JCO.2003.04.092
Carter, Corey A., Timothy Donahue, Leon Sun, Hongyu Wu, David G. McLeod, Christopher Amling, Raymond Lance, et al. “Temporarily deferred therapy (watchful waiting) for men younger than 70 years and with low-risk localized prostate cancer in the prostate-specific antigen era.J Clin Oncol 21, no. 21 (November 1, 2003): 4001–8. https://doi.org/10.1200/JCO.2003.04.092.
Carter, Corey A., et al. “Temporarily deferred therapy (watchful waiting) for men younger than 70 years and with low-risk localized prostate cancer in the prostate-specific antigen era.J Clin Oncol, vol. 21, no. 21, Nov. 2003, pp. 4001–08. Pubmed, doi:10.1200/JCO.2003.04.092.
Carter CA, Donahue T, Sun L, Wu H, McLeod DG, Amling C, Lance R, Foley J, Sexton W, Kusuda L, Chung A, Soderdahl D, Jackmaan S, Moul JW. Temporarily deferred therapy (watchful waiting) for men younger than 70 years and with low-risk localized prostate cancer in the prostate-specific antigen era. J Clin Oncol. 2003 Nov 1;21(21):4001–4008.

Published In

J Clin Oncol

DOI

ISSN

0732-183X

Publication Date

November 1, 2003

Volume

21

Issue

21

Start / End Page

4001 / 4008

Location

United States

Related Subject Headings

  • United States
  • Prostatic Neoplasms
  • Prostate-Specific Antigen
  • Proportional Hazards Models
  • Practice Patterns, Physicians'
  • Oncology & Carcinogenesis
  • Observation
  • Neoplasm Staging
  • Middle Aged
  • Medical Records