{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T22:28:28Z","timestamp":1783031308183,"version":"3.54.6"},"reference-count":28,"publisher":"Wiley","issue":"17","license":[{"start":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T00:00:00Z","timestamp":1757376000000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2025,9]]},"abstract":"ABSTRACT<\/jats:title>\n \n Patients and Methods<\/jats:title>\n In this multicenter longitudinal study, data from the Spanish Register in AS (AEU\u2010PIEM\/2014\/0001) were reviewed. The study focused on a cohort of AS patients registered between 2014 and 2019, featuring open inclusion criteria and diverse follow\u2010up strategies.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 3315 AS patients were recruited, with 2881 and 434 categorized into the low and intermediate risk groups based on NCCN grouping at inclusion. The median age was 67\u2009years, and only 11% underwent diagnostic biopsy guided by MRI. The median time between follow\u2010up visits was 6.03\u2009months. Over a median follow\u2010up of 62\u2009months (Q1\u20133: 43.78\u201385.58), 37% remained in AS, while 8% transitioned to watchful waiting due to aging or intercurrent disease. Death occurred in 199 (6%) of patients, with 3 due to prostate cancer progression and 196 attributed to other causes. At 2 and 5\u2009years, pathological progression\u2010free survival, metastasis\u2010free survival, and active treatment\u2010free survival were 68% and 51%, 99% and 99%, and 70% and 50%, respectively.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Midterm oncological outcomes of AS in Spain align with major international series. We denote underuse of guideline recommendations such as use of MRI or TP Bx for initial PCa characterization. Collaborative efforts are crucial in the search for algorithms, new imaging, or biomarkers to refine indications and transition to active treatments.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n ClinicalTrials.gov<\/jats:ext-link>\n identifier: NCT02865330\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/cam4.71173","type":"journal-article","created":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T04:49:12Z","timestamp":1757479752000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Real World Evidence of Active Surveillance for Prostate Cancer in Spain; Midterm Results"],"prefix":"10.1002","volume":"14","author":[{"given":"J.","family":"Rubio\u2010Briones","sequence":"first","affiliation":[{"name":"Hospital VITHAS 9 de Octubre Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0178-4567","authenticated-orcid":false,"given":"A.","family":"Borque\u2010Fernando","sequence":"additional","affiliation":[{"name":"Hospital Miguel Servet, IIS\u2010Aragon Zaragoza Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. 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