Quantifying the tradeoffs of active surveillance for low-risk prostate cancer: A clinical decision analysis.

Abstract

4636 Background: Recent results suggest that active surveillance is a reasonable alternative for men diagnosed with low-risk prostate cancer, but there is a lack of data on the tradeoffs of immediate treatment vs. delayed intervention to guide clinical decision-making. Existing studies using quality-adjusted outcomes are difficult to apply clinically due to differences in individual preferences. Further, benefits of treatment may vary substantially based on age and baseline health status. Methods: Monte Carlo simulations using Markov Models were used to simulate the life course of men diagnosed with low-risk prostate cancer in the modern PSA era when treated with radical prostatectomy or monitored with active surveillance. Primary outcomes were life expectancy and average years of side effects from treatment, and a clinical incremental