Germline testing for prostate cancer prognosis: implications for active surveillance

Based upon an evidence-based review of recently published manuscripts including our own studies, we first review germline variants that are significantly associated with prostate cancer aggressiveness and progression. We then discuss the clinical implication of germline variants in predicting grade reclassification of prostate cancer patients undergoing active surveillance. Finally, based on currently available evidence, we propose a working recommendation of germline testing and corresponding clinical management for localized prostate cancer patients, including those undergoing active surveillance.