To reduce treatment-related side effects in low-risk prostate cancer(PCa),both focal therapy and deferred treatments,including active surveillance(AS)and watchful waiting(WW),are worth considering over radical prostatectomy(RP).Therefore,this study aimed to compare long-term survival outcomes between focal therapy and AS/WW.Data were obtained and analyzed from the Surveillance,Epidemiology,and End Results(SEER)database.Patients with low-risk PCa who received focal therapy or AS/WW from 2010 to 2016 were included.Focal therapy included cryotherapy and laser ablation.Multivariate Cox proportional hazards models were used to compare overall mortality(OM)and cancer-specific mortality(CSM)between AS/WW and focal therapy,and propensity score matching(PSM)was performed to reduce the influence of bias and unmeasured confounders.A total of 19 292 patients with low-risk PCa were included in this study.In multivariate Cox proportional hazards model analysis,the risk of OM was higher in patients receiving focal therapy than those receiving AS/WW(hazard ratio[HR]=1.35,95％confidence interval[CI]:1.02-1.79,P=0.037),whereas no significant difference was found in CSM(HR=0.98,95％CI:0.23-4.11,P=0.977).After PSM,the OM and CSM of focal therapy and AS/WW showed no significant differences(HR=1.26,95％CI:0.92-1.74,P=0.149;and HR=1.26,95％CI:0.24-6.51,P=0.782,respectively).For patients with low-risk PCa,focal therapy was no match for AS/WW in decreasing OM,suggesting that AS/WW could bring more overall survival benefits.

Qi-Ming Yuan;Tian-Hai Lin;Kun Jin;Shi Qiu;Xiang-Hong Zhou;Di Jin;Jia-Kun Li;Lu Yang;Qiang Wei

Department of Urology,Institute of Urology,West China Hospital of Sichuan University,Chengdu 610041,China

亚洲男性学杂志（英文版）

[1]Qi-Ming Yuan;Tian-Hai Lin;Kun Jin;Shi Qiu;Xiang-Hong Zhou;Di Jin;Jia-Kun Li;Lu Yang;Qiang Wei-.The comparison of survival between active surveillance or watchful waiting and focal therapy for low-risk prostate cancer:a real-world study from the SEER database)[J].亚洲男性学杂志（英文版）,2022(03):305-310

watchful,unmeasured

comparison,survival,between,active,surveillance,waiting,focal,low,risk,cancer,real,world,study,from,SEER,database,To,reduce,related,effects,PCa,both,deferred,treatments,including,AS,WW,worth,considering,radical,prostatectomy,RP,Therefore,this,aimed,compare,long,term,outcomes,Data,were,obtained,analyzed,Surveillance,Epidemiology,End,Results,Patients,who,received,included,Focal,cryotherapy,laser,ablation,Multivariate,Cox,proportional,hazards,models,used,overall,mortality,OM,specific,CSM,propensity,score,matching,PSM,was,performed,influence,bias,confounders,total,patients,In,multivariate,analysis,higher,receiving,than,those,ratio,confidence,interval,whereas,no,significant,After,showed,differences,respectively,For,decreasing,suggesting,that,could,bring,more,benefits

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