The analysis of active surveillance for Japanese young early-stage prostate cancer patients: From the PRIAS-JAPAN study.

• DOI: 10.1200/jco.2025.43.5_suppl.351
• Publication Date: 2025-02-18T14:38:27Z
• Authors: Takuma Kato; Takahiro Kimura; Ryuji Matsumoto; Akira Yokomizo; Takuma Sato; Yoichiro Tohi; Haruki Kume; Koji Inoue; Hidefumi Kinoshita; Shinichi Sakamoto; Isao Hara; Hiroshi Fukuhara; Mikio Sugimoto

351 Background: The current status of active surveillance (AS) for early-stage young Japanese patients is unknown. We examined it from the data PRIAS-JAPAN, a multicenter prospective collaborative study AS in Japan. Methods: Initially, low-risk with PSA density (PSAD) <0.2 and 2 or fewer positive cores were eligible. eligibility criteria have since been revised accordingly, 2021, when MRI imaging was performed, inclusion allowed PSAD up to 0.25, no upper limit on number Gleason score (GS) 3+3 cases, half total intermediate-risk GS 3+4 cases. test every 3 months, rectal examination 6 biopsy at 1, 4, 7, 10 years, 5 years after that, recommendation secondary treatment confirming pathological deterioration. results clinical outcomes compared between aged 60 younger (Young group: Y-group, n=165) those over old (elderly E-group; n=1,109). Results: In median age 57 diagnosis 4.8 ng/ml, prostate volume 33.4 cm3, 0.15 ng/ml/c m3,T1c 149. At diagnosis, Y-group had significantly smaller volumes higher proportion cases than E-group. acceptance rate decreased increasing (1 st , nd rd, 4th year: 81.8%, 70.3%, 34.4%, 13.3%). reclassification increased time rd 28.7%, 30.8%, 27.3%, 50.0%). persistence time, 10-year 19.2%, significant difference two groups. metastasis-free survival (MFS), overall (VS), cancer-specific (CSS) rates 98.8%, 98.9%, 100%, respectively. Although OS lower (p=0.051, HR=2.29. 95%CI 1.004-5.21), MFS CSS did not differ more likely E-group choose prostatectomy (38.3%) as next treatment, while they want hormone therapy (4,7%) watchful waiting (6.5%). Conclusions: superior OS, there Metastasis-free year 13 ≤60y.o 55.7% 39.9% 19.2% 17.1% 100% 99% 60y.o< 58.2% 38.5% 16.3% 12.0% 98% Overall Cancer-specific 100.0% 98.9% 95.3% 97.9% 97.0% 92.2% 88.7% 99.9%