First results of active observation of patients with prostate cancer and low oncological risk

Abstract

The study objective is to improve results of treatment of patients with prostate cancer (PC) and low oncological risk.Materials and methods. Since November of 2019 at the Institute of Urology and Human Reproductive Health of the I.M. Sechenov First Moscow State Medical University 40 patients with PC and low oncological risk were included in the protocol of active observation. In all patients, the level of prostate-specific antigen was evaluated every 3 months, digital rectal examination was performed every 6 months, magnetic resonance tomography of the pelvis with intravenous contrast was performed every 12 months. Confirming biopsy of the prostate was performed once, 1 year after the beginning of observation. Every 6 months patients' quality of life was evaluated using the SF-36 (Short Form 36 Health Quality Survey), IIEF-5 (International Index of Erectile Function), IPSS (International Prostate Symptom Score), EPIC-26 (Expanded Prostate Cancer Index Composite) questionnaires.Results. Two (5 %) patients underwent surgical treatment due to PC progression. One (2.5 %) patient preferred treatment due to oncological anxiety. Mean value per the SF-36 questionnaire at the beginning of the study was 63.2 ± 11.5 for psychological component of health and 57.1 ± 9.8 for physical component of health. At the moment, the assessment of the psychological and physical components of health according to SF-36 is 69.5 ± 12.4 and 66.3 ± 8.9 points, respectively. Mean IIEF-5 value at the beginning of the study was 18.8 ± 4.2, currently it is 18.6 ± 3.9. At the beginning of the study mean IPSS value was 9.1 ± 2.1, currently it is 9.4 ± 1.9. For the EPIC-26 questionnaire mean value for all criteria initially was 56.1 ± 5.1, currently it is 68.2 ± 4.6.Conclusion. First results of active observation of patients with PC and low oncological risk demonstrated that this approach allows to avoid unnecessary treatment of patients who do not require immediate intervention and to start treatment on time in cases where it is required while preserving high quality of life for the patients.