BMC Urology | |
Active surveillance should not be routinely considered in ISUP grade group 2 prostate cancer | |
Comment | |
Sophie Plagakis1  Armando Stabile2  Alberto Briganti2  Riccardo Leni2  Giorgio Gandaglia2  Francesco Montorsi2  | |
[1] Flinders Medical Center, Adelaide, Australia;Unit of Urology/Division of Oncology; URI, IRCCS Ospedale San Raffaele, Milan, Italy;Vita-Salute San Raffaele University, Milan, Italy; | |
关键词: Prostate cancer; Active surveillance; Intermediate risk; Radical prostatectomy; Recurrence; | |
DOI : 10.1186/s12894-023-01315-5 | |
received in 2023-07-19, accepted in 2023-09-03, 发布年份 2023 | |
来源: Springer | |
【 摘 要 】
Active surveillance has been proposed as a therapeutic option in selected intermediate risk patients with biopsy grade group 2 prostate cancer. However, its oncologic safety in this setting is debated. Therefore, we conducted a non-systematic literature research of contemporary surveillance protocols including patients with grade group 2 disease to collect the most recent evidence in this setting. Although no randomized controlled trial compared curative-intent treatments, namely radical prostatectomy and radiotherapy vs. active surveillance in patients with grade group 2 disease, surgery is associated with a benefit in terms of disease control and survival when compared to expectant management in the intermediate risk setting. Patients with grade group 2 on active surveillance were at higher risk of disease progression and treatment compared to their grade group 1 counterparts. Up to 50% of those patients were eventually treated at 5 years, and the metastases-free survival rate was as low as 85% at 15-years. When considering low- and intermediate risk patients treated with radical prostatectomy, grade group 2 was one of the strongest predictors of grade upgrading and adverse features. Available data is insufficient to support the oncologic safety of active surveillance in all men with grade group 2 prostate cancer. Therefore, those patients should be counselled regarding the oncologic efficacy of upfront active treatment modalities and the lack of robust long-term data supporting the safety of active surveillance in this setting.
【 授权许可】
CC BY
© BioMed Central Ltd., part of Springer Nature 2023
【 预 览 】
Files | Size | Format | View |
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RO202311107922543ZK.pdf | 872KB | download |
【 参考文献 】
- [1]
- [2]
- [3]
- [4]
- [5]
- [6]
- [7]
- [8]
- [9]
- [10]
- [11]
- [12]
- [13]
- [14]
- [15]
- [16]
- [17]
- [18]
- [19]
- [20]
- [21]
- [22]
- [23]
- [24]
- [25]
- [26]
- [27]
- [28]
- [29]
- [30]
- [31]
- [32]
- [33]
- [34]
- [35]
- [36]
- [37]
- [38]
- [39]
- [40]
- [41]