Content area
Abstract
ABSTRACT
Patients and Methods
In this multicenter longitudinal study, data from the Spanish Register in AS (AEU‐PIEM/2014/0001) were reviewed. The study focused on a cohort of AS patients registered between 2014 and 2019, featuring open inclusion criteria and diverse follow‐up strategies.
Results
A total of 3315 AS patients were recruited, with 2881 and 434 categorized into the low and intermediate risk groups based on NCCN grouping at inclusion. The median age was 67 years, and only 11% underwent diagnostic biopsy guided by MRI. The median time between follow‐up visits was 6.03 months. Over a median follow‐up of 62 months (Q1–3: 43.78–85.58), 37% remained in AS, while 8% transitioned to watchful waiting due to aging or intercurrent disease. Death occurred in 199 (6%) of patients, with 3 due to prostate cancer progression and 196 attributed to other causes. At 2 and 5 years, pathological progression‐free survival, metastasis‐free survival, and active treatment‐free survival were 68% and 51%, 99% and 99%, and 70% and 50%, respectively.
Conclusions
Midterm oncological outcomes of AS in Spain align with major international series. We denote underuse of guideline recommendations such as use of MRI or TP Bx for initial PCa characterization. Collaborative efforts are crucial in the search for algorithms, new imaging, or biomarkers to refine indications and transition to active treatments.
Trial Registration
Details
; Esteban Escaño, L. M. 3 ; Wong, A. 4 ; Guijarro Cascales, A. 5 ; Gómez Gómez, E. 6 ; Gil Fabra, J. M. 2 ; Sanguedolce, F. 7 ; Gomez‐Veiga, F. 8 ; López González, P. A. 9 ; Plata Bello, A. 10 ; Rodríguez García, N. 11 ; Montesino Semper, M. 12 ; Suárez Novo, J. F. 13 ; Hajianfar, R. 14 ; Fumadó Ciutat, L. l. 15 ; González Alfaro, A. 16 ; Duarte Ojeda, J. M. 17 ; Bono Ariño, A. 18 ; Quicios Dorado, C. 19 ; Loizaga Iriarte, A. 20 ; García Fadrique, G. 21 ; Giménez Bachs, J. M. 22
; García Barreras, S. 23 ; Pallas Costa, Y. 24 ; Vilaseca Cabo, A. 25 ; Rodrigo Aliaga, M. 26 ; Campanario Pérez, F. 27 ; Servián, P. 28 ; Campá Bortoló, J. M. 29 ; Soto Delgado, M. 30 ; Rodríguez de Ledesma, J. M. 31 ; Sánchez Rodríguez, C. 32 ; Chantada Abal, V. 33 ; Hernández Martínez, Y. E. 34 ; Herrera Imbroda, B. 35
; Dolezal, P. 36 ; Gual Frau, J. 37 ; Medrano Llorente, P. 38 ; Moreno Jiménez, J. 39 ; Serrano Uribe, J. S. 40 ; Congregado Ruiz, C. B. 41 ; Reyes, A. 42 ; Fernández Aparicio, T. 43 ; García Rodríguez, J. 44 ; Cuadras Solé, M. 45 ; García Seguí, A. 46 ; Pacheco Bru, J. J. 47 ; Mayor de Castro, J. 48 ; Mira Moreno, A. 49 ; Molina Suárez, J. L. 50 1 Hospital VITHAS 9 de Octubre, Valencia, Spain
2 Hospital Miguel Servet, IIS‐Aragon, Zaragoza, Spain
3 Hospital Escuela Universitaria La Almunia, Zaragoza, Spain
4 Hospital Instituto Valenciano de Oncología, Valencia, Spain
5 Hospital Fundación Alcorcón, Madrid, Spain
6 Hospital Reina Sofía, Córdoba, Spain
7 Hospital Fundación Puigvert, Barcelona, Spain
8 Hospital Universitario de Salamanca, Salamanca, Spain
9 Hospital Virgen de la Arraixaca, Murcia, Spain
10 Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
11 Hospital Son Llatzer, Baleares, Spain
12 Hospital Virgen del Camino, Navarra, Spain
13 Hospital Universitario Bellvitge, Barcelona, Spain
14 Hospital Moises Broggi, Barcelona, Spain
15 Hospital del Mar, Barcelona, Spain
16 Hospital Móstoles, Madrid, Spain
17 Hospital 12 de Octubre, Madrid, Spain
18 Hospital San Jorge, Huesca, Spain
19 Hospital Fundación Jiménez Díaz, Madrid, Spain
20 Hospital Basurto, Vizcaya, Spain
21 Hospital Manises, Valencia, Spain
22 Hospital Universitario Albacete, Albacete, Spain
23 Hospital Ramón y Cajal, Madrid, Spain
24 Hospital General Universitario, Valencia, Spain
25 Hospital Clínic, Barcelona, Spain
26 Hospital General Universitario, Castellón, Spain
27 Hospital Complejo Asistencial Universitario, Palencia, Spain
28 Hospital Germans Trias i Pujol, Barcelona, Spain
29 Hospital Universitario de Araba, Alava, Spain
30 Hospital Puerta del Mar, Cádiz, Spain
31 Hospital CST Terrasa, Barcelona, Spain
32 Hospital Reina Sofía, Murcia, Spain
33 Hospital CHUAC, A Coruña, Spain
34 Hospital Manacor, Baleares, Spain
35 UGC Intercentros Urología Hospitales Universitarios Virgen de la Victoria y Regional, Málaga, Spain
36 Hospital Barbastro, Huesca, Spain
37 Hospital Xátiva, Valencia, Spain
38 Hospital Clínico Lozano Blesa, Zaragoza, Spain
39 Complejo Hospitalario, Jaen, Spain
40 Hospital Universitario Príncipe de Asturias, Madrid, Spain
41 Hospital Universitario Vírgen del Rocío, Sevilla, Spain
42 Hospital Calatayud, Ernest Lluch, Zaragoza, Spain
43 Hospital Morales Messeguer, Murcia, Spain
44 Hospital Universitario Central, Asturias, Spain
45 Hospital Vall d Hebrón, Barcelona, Spain
46 Hospital General Universitario Elche, Alicante, Spain
47 Hospital San Juan, Alicante, Spain
48 Hospital HGU Gregorio Marañón, Madrid, Spain
49 Hospital General de Elda, Alicante, Spain
50 Hospital Vírgen del Puerto, Extremadura, Spain