Active surveillance for prostate cancer： when to recommend delayed intervention

作     者：Kara N Babaian 

作者机构：Department of Urology University of California IrvineOrange CA USA 

出 版 物：《Asian Journal of Andrology》 (亚洲男性学杂志（英文版）)

年 卷 期：2015年第17卷第6期

页      面：885-887,I0006,I0007页

核心收录：

学科分类：0809[工学-电子科学与技术（可授工学、理学学位）] 07[理学] 070205[理学-凝聚态物理] 08[工学] 09[农学] 071007[理学-遗传学] 090102[农学-作物遗传育种] 0710[理学-生物学] 0805[工学-材料科学与工程（可授工学、理学学位）] 080502[工学-材料学] 0901[农学-作物学] 0836[工学-生物工程] 0702[理学-物理学] 

主　　题：Active surveillance intervention 

摘      要：There are no agreed upon guidelines for placing patients on active surveillance （AS）. Therefore, there are no absolute criteria for taking patients offAS and when to recommend treatment. The criteria used to define progression are currently based on prostate specific antigen （PSA） kinetics, biopsy reclassification, and change in clinical stage. Multiple studies have evaluated predictors of progression such as PSA, PSA density （PSAD）, prostate volume, core positivity, and visible lesion on multiparametric magnetic resonance imaging （mpMRI）. Furthermore, published nomograms designed to predict indolent prostate cancer do not perform well when used to predict progression. Newer biomarkers have also not performed well to predict progression. These findings highlight that clinical and pathologic variables are not enough to identify patients that will progress while on AS. In the future, with the use of imaging, biomarkers, and gene expression assays, we should be better equipped to diagnose/stage prostate cancer and to distinguish between insignificant and significant disease.