Kelas : 3EB24
NPM : 29214956
Review
Article 1
When no treatment is the best treatment: Active
surveillance strategies for low risk prostate cancers
Highlights
• Active surveillance is a standard approach for
managing low grade, organ-confined prostate cancers.
• Careful selection and close monitoring of eligible
patients is necessary.
• Magnetic resonance imaging is a useful tool for
stratifying risk and for monitoring men on active surveillance
Abstract
Although the incidence of prostate cancer is rising
due to PSA screening and increased life expectancy, the metastatic potential of
low-grade, organ-confined disease remains low. An increasing number of studies
suggest that radical treatment in such cases confers little or no survival
benefit at a significant cost to morbidity. Active surveillance is a promising
management approach of such low-risk cancers: eligible patients are selected
based on clinical and pathological findings at diagnosis and are regularly
monitored with digital rectal examinations, PSA testing and biopsies. Treatment,
however, is deferred until and unless there is evidence of disease progression.
This is a key difference from watchful waiting, where treatment is avoided
until and unless there are symptoms. The purpose of this work is to review the
rationale and evidence behind active surveillance and to offer an overview of
current active surveillance strategies and outcomes.
Keywords
- Prostate cancer;
- Active surveillance;
- Clinically significant cancer;
- Reclassification;
- Magnetic
resonance imaging
Source: http://www.sciencedirect.com/science/article/pii/S0305737217300841
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