A study just published by van As et al. in the UK suggests the possible value of the free/total PSA ratio as a predictor of the time to deferred treatment in a well-defined group of untreated men with early stage, low grade disease being followed with active surveillance.
The study involved 326 men followed since 2002 with a median follow-up time of 22 months. Sixty-five of the patients (6.9 percent) required deferred radical surgery; seven (2 percent) died of non-prostate cancer-related causes; and 238 remain on active surveillance. Initial clinical stage (T stage) and the free/total PSA ratio were identified as the two independent predictors of time to definitive treatment (in addition to other established prognostic factors such as Gleason grade and PSA level).
This study is a single institution study from a major UK center, but it offers additional evidence for the possibility of selectively defining men at highest risk for progression after diagnosis with relatively non-aggressive forms of prostate cancer.
Filed under: Management
