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Active surveillance for intermediate-risk prostate cancer.
Madhur Nayan1, Filipe L F Carvalho1, Adam S Feldman2
1Department of Urology, Massachusetts General Hospital, 55 Fruit St, GRB 1100, Boston, MA, 02114, USA.
World Journal of Urology
|January 19, 2022
Summary
Active surveillance (AS) for intermediate-risk prostate cancer is increasingly used but its safety is uncertain. More research is needed to determine if AS is safe for select intermediate-risk prostate cancer patients.
Area of Science:
- Oncology
- Urology
- Cancer Management
Background:
- Active surveillance (AS) is a standard approach for low-risk prostate cancer.
- Its application to intermediate-risk (IR) prostate cancer is growing but lacks definitive safety data.
- A minority of IR patients currently utilize AS due to safety concerns.
Purpose of the Study:
- To review the current literature on AS for IR prostate cancer.
- To explore the uncertainties and limitations in managing IR prostate cancer with AS.
- To highlight the need for further research in this area.
Main Methods:
- A narrative review of existing literature.
- Focused analysis on studies describing AS for IR prostate cancer.
- Examination of definitions, guidelines, and evidence limitations.
Main Results:
- The safety of AS for IR prostate cancer remains undetermined.
- Variations in definitions and guidelines contribute to uncertainty.
- Current evidence from observational studies and trials has significant limitations.
Conclusions:
- Randomized trials are lacking for AS in IR prostate cancer.
- Further research is essential to identify suitable candidates for AS in IR disease.
- Establishing the safety of AS for select IR prostate cancer patients requires more investigation.
