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Updated: Mar 21, 2026

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Active Surveillance for Localized Prostate Cancer: A Retrospective Single-Center Study.

Akihiko Sugino1, Yoshiyuki Miyazawa1, Shun Nakazawa1

  • 1Gunma University Graduate School of Medicine & Gunma University Hospital, Department of Urology, Maebashi, Japan.

International Journal of Urology : Official Journal of the Japanese Urological Association
|March 20, 2026
PubMed
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This summary is machine-generated.

Active surveillance for prostate cancer in Japan shows good long-term safety and durability. Improving repeat biopsy adherence can enhance patient management and outcomes.

Area of Science:

  • Urology
  • Oncology
  • Clinical Research

Background:

  • Active surveillance (AS) is a strategy to manage prostate cancer, minimizing overtreatment.
  • Adoption of AS in Japan is limited, necessitating Japan-specific clinical outcome data.
  • This study evaluates the safety and efficacy of AS in a Japanese cohort.

Purpose of the Study:

  • To assess the clinical outcomes of patients with prostate cancer managed under active surveillance (AS) in Japan.
  • To provide institution-specific evidence on AS safety and durability.
  • To identify factors influencing AS persistence and patient adherence to protocols.

Main Methods:

  • Retrospective review of 86 patients who underwent AS between 2012 and 2024.
  • Inclusion criteria: ≤ cT2a disease, PSA ≤ 10 ng/mL, Gleason score 3+3, ≤2 positive cores, with exceptions for GS 3+4 or 4+3 based on preference.
Keywords:
active surveillancelocalizedprostate cancer

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  • AS discontinuation criteria: clinical/pathological progression or patient preference; follow-up included repeat biopsies.
  • Main Results:

    • Mean follow-up was 48 months; no prostate cancer-specific deaths occurred.
    • AS persistence rates were 89% (1 year), 55% (5 years), and 27% (10 years). Older age (≥75 years) correlated with longer AS persistence.
    • Pathological upgrading occurred in 35% of repeat biopsies. Acceptance of 1-year repeat biopsy increased from 46% to 64% over time.

    Conclusions:

    • Active surveillance demonstrates favorable long-term safety and durability for prostate cancer management in Japan.
    • Adherence to repeat biopsy protocols is crucial for optimizing AS management.
    • Findings support the feasibility of AS in Japan with potential for wider adoption.