Active Surveillance for Prostate Cancer: A Systematic Review of the Literature

被引:488
作者
Dall'Era, Marc A. [1 ]
Albertsen, Peter C. [2 ]
Bangma, Christopher [3 ]
Carroll, Peter R. [4 ]
Carter, H. Ballentine [5 ]
Cooperberg, Matthew R. [4 ]
Freedland, Stephen J. [6 ,7 ]
Klotz, Laurence H. [8 ]
Parker, Christopher [9 ,10 ]
Soloway, Mark S. [11 ]
机构
[1] Univ Calif Davis, Dept Urol, Med Ctr, Sacramento, CA 95817 USA
[2] Univ Connecticut, Ctr Hlth, Dept Urol, Farmington, CT USA
[3] Erasmus MC, Dept Urol, Rotterdam, Netherlands
[4] Univ Calif San Francisco, Dept Urol, Hellen Diller Family Comprehens Canc Ctr, San Francisco, CA 94143 USA
[5] Johns Hopkins Univ, Sch Med, Dept Urol, James Buchanan Brady Urol Inst, Baltimore, MD 21205 USA
[6] Durham Vet Affairs Med Ctr, Durham, NC USA
[7] Duke Univ, Dept Surg Urol & Pathol, Duke Prostate Ctr, Durham, NC USA
[8] Univ Toronto, Sunnybrook Hlth Sci Ctr, Dept Surg, Div Urol, Toronto, ON, Canada
[9] Royal Marsden NHS Trust, Sutton, Surrey, England
[10] Inst Canc Res, Sutton, Surrey, England
[11] Univ Miami, Sch Med, Dept Urol, Miami, FL USA
关键词
Prostate cancer; Active surveillance; Expectant management; Review; PSA VELOCITY; ANTIGEN KINETICS; REPEAT BIOPSY; LIFE-STYLE; MEN; MANAGEMENT; RISK; INTERVENTION; OUTCOMES; DEATH;
D O I
10.1016/j.eururo.2012.05.072
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
100201 [内科学]; 100221 [泌尿外科学];
摘要
Context: Prostate cancer (PCa) remains an increasingly common malignancy worldwide. The optimal management of clinically localized, early-stage disease remains unknown, and profound quality of life issues surround PCa interventions. Objective: To systematically summarize the current literature on the management of low-risk PCa with active surveillance (AS), with a focus on patient selection, outcomes, and future research needs. Evidence acquisition: A comprehensive search of the PubMed and Embase databases from 1980 to 2011 was performed to identify studies pertaining to AS for PCa. The search terms used included prostate cancer and active surveillance or conservative management or watchful waiting or expectant management. Selected studies for outcomes analysis had to provide a comprehensive description of entry characteristics, criteria for surveillance, and indicators for further intervention. Evidence synthesis: Data from seven large AS series were reviewed. Inclusion criteria for surveillance vary among studies, and eligibility therefore varies considerably (4-82%). PCa-specific mortality remains low (0-1%), with the longest published-median follow-up being 6.8 yr. Up to one-third of patients receive secondary therapy after a median of about 2.5 yr of surveillance. Surveillance protocols and triggers for intervention vary among institutions. Most patients are treated for histologic reclassification (27-100%) or prostate-specific antigen doubling time <3 yr (13-48%), while 7-13% are treated with no evidence of progression. Repeat prostate biopsy with a minimum of 12 cores appears to be important for monitoring patients for changes in tumor histology over time. Conclusions: AS for PCa offers an opportunity to limit intervention to patients who will likely benefit the most from radical treatment. This approach confers a low risk of disease-specific mortality in the short to intermediate term. An early, confirmatory biopsy is essential for limiting the risk of underestimating tumor grade and amount. (C) 2012 European Association of Urology. Published by Elsevier B. V. All rights reserved.
引用
收藏
页码:976 / 983
页数:8
相关论文
共 55 条
[1]
Role of Prostate Specific Antigen and Immediate Confirmatory Biopsy in Predicting Progression During Active Surveillance for Low Risk Prostate Cancer [J].
Adamy, Ari ;
Yee, David S. ;
Matsushita, Kazuhito ;
Maschino, Alexandra ;
Cronin, Angel ;
Vickers, Andrew ;
Guillonneau, Bertrand ;
Scardino, Peter T. ;
Eastham, James A. .
JOURNAL OF UROLOGY, 2011, 185 (02) :477-482
[2]
Clinical utility of diffusion-weighted magnetic resonance imaging in prostate cancer [J].
Afaq, Asim ;
Koh, Dow-Mu ;
Padhani, Anwar ;
van As, Nicholas ;
Sohaib, S. Aslam .
BJU INTERNATIONAL, 2011, 108 (11) :1716-1722
[3]
[Anonymous], 31 C SOC INT UR OCT
[4]
Characteristics of insignificant clinical T1c prostate tumors - A contemporary analysis [J].
Bastian, PJ ;
Mangold, LA ;
Epstein, JI ;
Partin, AW .
CANCER, 2004, 101 (09) :2001-2005
[5]
Pathological Upgrading and Up Staging With Immediate Repeat Biopsy in Patients Eligible for Active Surveillance [J].
Berglund, Ryan K. ;
Masterson, Timothy A. ;
Vora, Kinjal C. ;
Eggener, Scott E. ;
Eastham, James A. ;
Guillonneau, Bertrand D. .
JOURNAL OF UROLOGY, 2008, 180 (05) :1964-1967
[6]
Predictors of Unfavourable Repeat Biopsy Results in Men Participating in a Prospective Active Surveillance Program [J].
Bul, Meelan ;
van den Bergh, Roderick C. N. ;
Rannikko, Antti ;
Valdagni, Riccardo ;
Pickles, Tom ;
Bangma, Chris H. ;
Roobol, Monique J. .
EUROPEAN UROLOGY, 2012, 61 (02) :370-377
[7]
Expectant management of prostate cancer with curative intent: An update of the Johns Hopkins experience [J].
Carter, H. Ballentine ;
Kettermann, Anna ;
Warlick, Christopher ;
Metter, E. Jeffrey ;
Landis, Patricia ;
Walsh, Patrick C. ;
Epstein, Jonathan I. .
JOURNAL OF UROLOGY, 2007, 178 (06) :2359-2364
[8]
International Variation in Prostate Cancer Incidence and Mortality Rates [J].
Center, Melissa M. ;
Jemal, Ahmedin ;
Lortet-Tieulent, Joannie ;
Ward, Elizabeth ;
Ferlay, Jacques ;
Brawley, Otis ;
Bray, Freddie .
EUROPEAN UROLOGY, 2012, 61 (06) :1079-1092
[9]
Pathological Outcomes of Candidates for Active Surveillance of Prostate Cancer [J].
Conti, Simon L. ;
Dall'Era, Marc ;
Fradet, Vincent ;
Cowan, Janet E. ;
Simko, Jeffery ;
Carroll, Peter R. .
JOURNAL OF UROLOGY, 2009, 181 (04) :1628-1633
[10]
Conti SL., 2009, J Urol, V181, P16281633