Younger Men With Prostate Cancer Have Lower Risk of Upgrading While on Active Surveillance: A Meta-analysis and Systematic Review of the Literature

Abstract Active surveillance has become a popular option for patients with low risk prostate cancer. Our objective was to examine the correlation between age and the risk of Gleason upgrading and biopsy progression. A systematic search was conducted. Eight studies met our eligibility criteria including 6522 patients with a median age of 65.8 (41-86) years. Per decade decrease in age, the pooled odds ratio and hazard ratio (CI 95%) for Gleason upgrading were 0.83 (0.73-0.94) and 0.87 (0.82-0.92), and for biopsy progression were 0.80 (0.74-0.86) and 0.88 (0.79-0.99), respectively. Overall, younger patients have a lower risk of GS upgrading and biopsy progression.