TY - JOUR
T1 - Active surveillance for prostate cancer
T2 - Current evidence and contemporary state of practice
AU - Tosoian, Jeffrey J.
AU - Carter, H. Ballentine
AU - Lepor, Abbey
AU - Loeb, Stacy
N1 - Publisher Copyright:
© 2016 Macmillan Publishers Limited.
PY - 2016/4/1
Y1 - 2016/4/1
N2 - Prostate cancer remains one of the most commonly diagnosed malignancies worldwide. Early diagnosis and curative treatment seem to improve survival in men with unfavourable-risk cancers, but significant concerns exist regarding the overdiagnosis and overtreatment of men with lower-risk cancers. To this end, active surveillance (AS) has emerged as a primary management strategy in men with favourable-risk disease, and contemporary data suggest that use of AS has increased worldwide. Although published surveillance cohorts differ by protocol, reported rates of metastatic disease and prostate-cancer-specific mortality are exceedingly low in the intermediate term (5-10 years). Such outcomes seem to be closely associated with programme-specific criteria for selection, monitoring, and intervention, suggesting that AS-like other management strategies-could be individualized based on the level of risk acceptable to patients in light of their personal preferences. Additional data are needed to better establish the risks associated with AS and to identify patient-specific characteristics that could modify prognosis.
AB - Prostate cancer remains one of the most commonly diagnosed malignancies worldwide. Early diagnosis and curative treatment seem to improve survival in men with unfavourable-risk cancers, but significant concerns exist regarding the overdiagnosis and overtreatment of men with lower-risk cancers. To this end, active surveillance (AS) has emerged as a primary management strategy in men with favourable-risk disease, and contemporary data suggest that use of AS has increased worldwide. Although published surveillance cohorts differ by protocol, reported rates of metastatic disease and prostate-cancer-specific mortality are exceedingly low in the intermediate term (5-10 years). Such outcomes seem to be closely associated with programme-specific criteria for selection, monitoring, and intervention, suggesting that AS-like other management strategies-could be individualized based on the level of risk acceptable to patients in light of their personal preferences. Additional data are needed to better establish the risks associated with AS and to identify patient-specific characteristics that could modify prognosis.
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U2 - 10.1038/nrurol.2016.45
DO - 10.1038/nrurol.2016.45
M3 - Review article
C2 - 26954332
AN - SCOPUS:84960172691
SN - 1759-4812
VL - 13
SP - 205
EP - 215
JO - Nature Reviews Urology
JF - Nature Reviews Urology
IS - 4
ER -