Related Experiment Video
Updated: Mar 25, 2026
A New Technique for Treating Low-risk Prostate Cancer—Super Active Surveillance
Published on: November 7, 2025
Predictive Factors for Reclassification and Relapse in Prostate Cancer Eligible for Active Surveillance: A Systematic
Fausto Petrelli1, Ivano Vavassori2, Mary Cabiddu1
1Oncology Division, Azienda Socio-Sanitaria Territoriale Bergamo Ovest, Treviglio, BG, Italy.
Objective:
To systematically evaluate the evidence on the predictors of the upgrading and biochemical recurrence of prostate cancer (PC) in those patients with low-risk disease assigned to active surveillance (AS).
Materials And Methods:
An electronic search of the PubMed, SCOPUS, Web of Science, CINAHL, Cochrane Library, Google Scholar, and Embase databases was performed for all reports that included detailed results of multivariate analyses of the predictors of PC reclassification and biochemical relapse during AS. Cumulative analyses of available hazard ratios (HRs) and their corresponding 95% confidence intervals were conducted using the RevMan 5.3 software to assess the potential predictors of PC upgrading and recurrence. Both random-effect model meta-analysis and Hartung-Knapp-Sidik-Jonkman meta-analysis method were applied to obtain the pooled HR for each covariate.
Results:
In the 32 articles analyzed, encompassing about 24,236 patients with early-stage PC, the 3 clinicopathological variables significantly associated with histological progression during AS were: prostate-specific antigen-density (HR 2.46; P = .0001); 2 positive cores (HR 1.54; P = .006); and race (HR 2; P = .04). Age, prostate-specific antigen levels, and suspicion on magnetic resonance imaging were not significantly associated with increased risk of progression of PC.
Conclusion:
We identified 3 strong predictors for the upgrading of PC during AS. These should be systematically evaluated to enable patients with low-risk disease to be treated with AS.
