Low‐risk Localized Prostate Cancer: Are We Ready to Tell Patients That Active Surveillance Is the Preferred Option?

Brewster, Simon

doi:10.1111/j.1464-410x.2008.07848.x

Cited by 2 publications

(2 citation statements)

References 29 publications

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“…Earlier studies of men diagnosed between 1994 and 2002 indicated that men who were followed by "expectant management" were being seen by primary care physicians as opposed to specialists (10). In contrast, AS is now indicated for younger men with low-risk disease, involves very rigorous follow-up, and includes the option for curative intent, depending on the changes in tumor characteristics during follow-up (11). Thus, physicians' viewpoint about and their recommendation of this option to their patients are evolving.…”

mentioning

confidence: 99%

Regional, Provider, and Economic Factors Associated With the Choice of Active Surveillance in the Treatment of Men With Localized Prostate Cancer

Hamilton

Wu²,

Lipscomb³

et al. 2012

JNCI Monographs

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Data on initial treatment of 8232 cases of localized prostate cancer diagnosed in 2004 were obtained by medical record abstraction (including hospital and outpatient locations) from seven state cancer registries participating in the Centers for Disease Control and Prevention's Breast and Prostate Cancer Data Quality and Patterns of Care Study. Distinction was made between men receiving no therapy with no monitoring plan (no therapy/no plan [NT/NP]) and those receiving active surveillance (AS). Overall, 8.6% received NT/NP and 4.7% received AS. Older age at diagnosis, lower clinical risk group, and certain registry locations were significant predictors of use of both AS and NT/NP. AS was also related to having more severe comorbidities, whereas nonwhite race was predicted receiving NT/NP. Men receiving AS lived in areas with a higher number of urologists per 100 000 men than those receiving NT/NP. In summary, physician and clinical factors were stronger predictors of AS, whereas demographic and regional factors were related to receiving NT/NP. Physicians appear reluctant to recommend AS for younger patients with no comorbidities.

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confidence: 99%

Regional, Provider, and Economic Factors Associated With the Choice of Active Surveillance in the Treatment of Men With Localized Prostate Cancer

Hamilton

Wu²,

Lipscomb³

et al. 2012

JNCI Monographs

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“…More men are being diagnosed with early localised disease with small foci of cancer. Almost 32 000 men are being diagnosed with CaP every year in the UK, yet only 10 000 die because of it [1]. Since the majority of newly diagnosed cases are slow growing and never progress to metastatic disease, treating clinicians face the dilemma of when and how to treat localised disease.…”

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confidence: 99%

Focal Therapy is an Option for the Majority of Localised Prostate Cancers: A Histopathological Study of Contemporary UK Radical Prostatectomies

Aslam

Turner

Brewster

2011

British Journal of Medical and Surgical Urology

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Objectives: Focal therapy for prostate cancer offers a management option intermediate between active surveillance and radical therapy for small volume, low grade localised prostate cancer. We studied a series of UK radical prostatectomies (RP) performed for organ-confined prostate cancer to identify the proportion of cases potentially suitable for pure lesion only focal therapy (PLFT) or focal hemi-gland ablation (FHA). Methods: The pathological features of 309 RP specimens were studied. Patients were grouped into the following categories: group A: unifocal cancer; group B: multifocal disease where only the index cancer was significant (Epstein's criteria); group C: unilateral multifocal significant disease; group D: bilateral multifocal significant disease. Results: 56% (172) patients were candidates for PLFT, including 70 group A cases plus 102 group B cases. Group C comprised 4% (11) cases who are candidates for FHA. Thus 60% (183) cases were candidates for either PLFT or FHA. Conclusions: A significant number of patients are potential candidates for focal therapy in this RP series. We encourage prospective clinical trials investigating the oncological safety and outcomes of focal therapy in treating low and intermediate risk localised prostate cancer.

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Low‐risk Localized Prostate Cancer: Are We Ready to Tell Patients That Active Surveillance Is the Preferred Option?

Cited by 2 publications

References 29 publications

Regional, Provider, and Economic Factors Associated With the Choice of Active Surveillance in the Treatment of Men With Localized Prostate Cancer

Regional, Provider, and Economic Factors Associated With the Choice of Active Surveillance in the Treatment of Men With Localized Prostate Cancer

Focal Therapy is an Option for the Majority of Localised Prostate Cancers: A Histopathological Study of Contemporary UK Radical Prostatectomies

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