Deferred Treatment in Patients with Localized Prostate Cancer

Interim reports of two large trials of prostate cancer screening (JW Gen Med Mar 18 2009) have led to increased scrutiny of current screening and management paradigms for prostate cancer. Although outcomes are improved in patients who receive definitive local therapy for clinically significant localized disease, data showing similar improvements in patients with low-risk, early-stage disease are lacking. Deferred treatment and active surveillance (expectant management with rigorous monitoring and the option of curative therapy should signs of progression develop) represent other — less commonly used — alternatives, but data are insufficient on the long-term outcomes with these approaches. To evaluate the consequences of deferred treatment, …