{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T20:38:56Z","timestamp":1790714336967,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100011933","name":"Department of Surgery, University of Manitoba","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011933","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To report long\u2010term oncological outcomes of men with intermediate\u2010risk prostate cancer managed with active surveillance at a single centre.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Subjects\/Patients and Methods<\/jats:title>\n                    <jats:p>We retrospectively analysed a prospectively maintained Manitoba Prostate Centre active surveillance database. Included were men with disease classed per National Comprehensive Cancer Network risk categories: very low\u2010, low\u2010, favourable intermediate\u2010, and unfavourable intermediate\u2010risk prostate cancer managed with surveillance (2004\u20132023). Active surveillance involved serial prostate\u2010specific antigen testing, digital rectal exam, and confirmatory\/surveillance biopsies. Outcomes were treatment\u2010free survival, metastasis\u2010free survival, prostate cancer\u2013specific survival, overall survival, and biopsy grade progression. Kaplan\u2013Meier estimated survival; Cox regression evaluated variables associated with outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 561 men, the median age was 65\u2009years (interquartile range 59\u201369) and the median follow\u2010up was 4.4\u2009years. Overall, 256 men (45.6%) transitioned to definitive treatment. Five\u2010year treatment\u2010free survival declined stepwise by risk group: 84.8% in very low\u2010risk, 61.4% in low\u2010risk, 50.0% in favourable intermediate\u2010risk, and 21.4% in unfavourable intermediate\u2010risk disease (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). On multivariable analysis, older age, higher prostate\u2010specific antigen density, and grade group \u22652 were independently associated with earlier treatment. Metastatic progression and prostate cancer\u2013specific mortality were rare across the cohort, with higher event rates observed among patients with unfavourable intermediate\u2010risk disease.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this real\u2010world active surveillance cohort, the likelihood of remaining on surveillance differed substantially by baseline risk, with unfavourable intermediate\u2010risk disease associated with earlier transition to treatment and higher risks of disease progression. Older age, higher prostate\u2010specific antigen density, and grade group \u22652 were independently associated with discontinuation of active surveillance. Despite less intensive surveillance protocols, rates of metastatic progression and prostate cancer\u2013specific mortality remained low, particularly among patients with low\u2010risk and favourable intermediate\u2010risk disease, supporting active surveillance as a viable management strategy in carefully selected men beyond low\u2010risk disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.70318","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T12:51:06Z","timestamp":1779281466000},"page":"297-305","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Active surveillance for intermediate risk prostate cancer: the Manitoba Prostate Center experience"],"prefix":"10.1111","volume":"138","author":[{"given":"Steven","family":"Lu","sequence":"first","affiliation":[{"name":"Section of Urology, Department of Surgery, Rady Faculty of Health Sciences University of Manitoba  Winnipeg MB Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7090-004X","authenticated-orcid":false,"given":"Connor","family":"Roque","sequence":"additional","affiliation":[{"name":"Rady Faculty of Health Sciences, Max Rady College of Medicine University of Manitoba  Winnipeg MB Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeff","family":"Saranchuk","sequence":"additional","affiliation":[{"name":"Section of Urology, Department of Surgery, Rady Faculty of Health Sciences University of Manitoba  Winnipeg MB Canada"},{"name":"Dr. Ernest W. Ramsey Manitoba Prostate Center CancerCare Manitoba  Winnipeg MB Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1469-0770","authenticated-orcid":false,"given":"Ardalan E.","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Section of Urology, Department of Surgery, Rady Faculty of Health Sciences University of Manitoba  Winnipeg MB Canada"},{"name":"Dr. Ernest W. Ramsey Manitoba Prostate Center CancerCare Manitoba  Winnipeg MB Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,20]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000002757"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.55.1192"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2016.06.007"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000000713"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2024.03.027"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2024.0019"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2013.03.033"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euo.2018.04.018"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euo.2020.03.002"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2214122"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1615869"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2017.06.048"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2016.06.102"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.31.4252"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000002354"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000000742"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2015.06.012"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2019.12.017"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2021.12.007"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1801993"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2019.03.016"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2019.03.001"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000004559"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2025.03.019"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000002685"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2016.01.120"}],"container-title":["BJU International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/bjui-journals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bju.70318","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/bjui-journals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/bju.70318","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/bjui-journals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bju.70318","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T16:29:26Z","timestamp":1784305766000},"score":1,"resource":{"primary":{"URL":"https:\/\/bjui-journals.onlinelibrary.wiley.com\/doi\/10.1111\/bju.70318"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,20]]},"references-count":26,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1111\/bju.70318"],"URL":"https:\/\/doi.org\/10.1111\/bju.70318","archive":["Portico"],"relation":{},"ISSN":["1464-4096","1464-410X"],"issn-type":[{"value":"1464-4096","type":"print"},{"value":"1464-410X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,20]]},"assertion":[{"value":"2026-05-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}