PMC

Cumulative incidence of secondary outcomes: treatment (gray line), grade reclassification (gold line), and reclassification by grade or cancer extent (dashed blue line).

Cumulative hazard of death as a result of any cause (dashed line) and prostate cancer death or metastasis (solid line).

Cumulative incidence of Gleason grade reclassification (GR) for men with very-low-risk prostate cancer (solid lines) and low-risk prostate cancer (dashed lines): all GR (blue), GR to 3 + 4 (gold), and GR to 4 + 3 and greater (gray).

CONSORT diagram for the Johns Hopkins active surveillance program. (*) Treatment is recommended in all cases of grade reclassification (ie, Gleason score upgrading). (†) Death from nonprostate cancer (PCA) causes. (‡) Includes five men who died of non-PCA causes after treatment. (§) Includes 27 men who were undecided on treatment at the time of analysis, eight men with no treatment data available, and two men who were found to have metastatic disease shortly after grade reclassification and subsequently died of PCA without treatment of their local disease. (‖) Includes four men who died of non-PCA causes after treatment. (¶) Includes 54 men who elected continued observation and 15 men with no treatment data available.