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    Men who delay RP show no added risk of adverse pathology

    Findings should reassure favorable-risk patients considering active surveillance

    New Orleans—After accounting for the risk of reclassification, carefully monitored men with favorable-risk prostate cancer who enroll in active surveillance and undergo delayed surgery are no more likely to demonstrate adverse features associated with 15-year prostate cancer-specific mortality than their counterparts who elect immediate curative treatment, say researchers from the Johns Hopkins University Brady Urological Institute, Baltimore.   

    READ: Active surveillance for PCa has ‘hit the prime time’

    Comparisons between the delayed and immediate surgery groups showed those having delayed surgery were significantly older and had a slightly but significantly higher PSA density at diagnosis. However, the proportion of men with adverse pathology at surgery (ie, primary Gleason pattern of 4 or 5, seminal vesicle invasion, or positive lymph nodes) was not significantly different in the delayed and immediate surgery groups (21.3% vs. 17%, p=.32). And, in an unconditional logistic regression analysis adjusting for age, PSA density, and distribution of very low-risk and low-risk men, there was no statistically significant difference comparing the delayed to the immediate surgery group in the risk of having adverse pathology (p=.13), reported study co-author Mufaddal Mamawala, MBBS, MPH.

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    Cheryl Guttman Krader
    Cheryl Guttman Krader is a contributor to Dermatology Times, Ophthalmology Times, and Urology Times.

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    • Go read Dawn Collins' column on Malpractice and see if you can find the disconnect.