Active surveillance for prostate cancer: current evidence and contemporary state of practice

Jeffrey J. Tosoian, H Ballentine Carter, Abbey Lepor, Stacy Loeb

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
JournalNature Reviews Urology
DOIs
StateAccepted/In press - Mar 8 2016

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Prostatic Neoplasms
Neoplasms
Patient Selection
Early Diagnosis
Survival
Mortality
Medical Overuse
Therapeutics

ASJC Scopus subject areas

  • Urology

Cite this

Active surveillance for prostate cancer : current evidence and contemporary state of practice. / Tosoian, Jeffrey J.; Carter, H Ballentine; Lepor, Abbey; Loeb, Stacy.

In: Nature Reviews Urology, 08.03.2016.

Research output: Contribution to journalArticle

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