Prospective Evaluation of Selection Criteria for Active Surveillance in Japanese Patients with Stage T1cN0M0 Prostate Cancer

Kakehi, Yoshiyuki; Shiraishi, Takeshi; Ogawa, Osamu; Suzukamo, Yoshimi; Fukuhara, Shunichi; Saito, Yuko; Tobisu, Ken Ichi; Kakizoe, Tadao; Shibata, Taro; Fukuda, Haruhiko; Akakura, Koichiro; Suzuki, Hiroyoshi; Shinohara, Nobuo; Egawa, Shin; Irie, Akira; Sato, Teruko; Maeda, Osamu; Meguro, Norio; Sumiyoshi, Yoshiteru; Suzuki, Takanori; Shimizu, Nobuaki; Arai, Yoichi; Terai, Akito; Kato, Takumi; Habuchi, Tomonori; Fujimoto, Hiroyuki; Niwakawa, Masashi

doi:10.1093/jjco/hym161

Cited by 71 publications

(70 citation statements)

References 18 publications

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“…For seven men who discontinued AS, reasons are unknown. Kakehi et al 26 reported that during the observation period, no serious adverse events were observed: not in the AS program group and not in those men who chose immediate treatment.…”

Section: Active Surveillancementioning

confidence: 99%

“…Klotz et al, 23 Carter et al 24,25 and Kakehi et al 26 have all initiated studies regarding the value of AS (Table 2). Klotz et al 23 reported on the long-term clinical results of a large, AS cohort with localized PC at the beginning of this year.…”

Section: Active Surveillancementioning

confidence: 99%

“…a smaller amount of T2 cancers are included in the John Hopkins pro- gram. Kakehi et al 26 reported the first prospective study on AS in Japanese patients where PC was detected using only a PSA elevation. The study included 134 men; of whom 118 chose the AS program and 16 chose immediate curative treatment at enrolment.…”

Section: Active Surveillancementioning

confidence: 99%

“…Three men died due to other disease, while five men were lost to follow-up. 26 Of the 118 patients who chose AS as initial treatment, 54 (46%) remained on AS for the maximal observation period of 54 months. Reasons for discontinuing AS were: a PSA doubling time f2 years (17/65), pathology progression (16/65), change in T-stage (1/65), patient's preference (15/65) and comorbidities (8/65).…”

Section: Active Surveillancementioning

confidence: 99%

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PSA-based prostate cancer screening: the role of active surveillance and informed and shared decision making

Venderbos¹,

Roobol²

2011

Asian J Androl

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Since the first publication describing the identification of prostate-specific antigen (PSA) in the 1960s, much progress has been made. The PSA test changed from being initially a monitoring tool to being also used as a diagnostic tool. Over time, the test has been heavily debated due to its lack of sensitivity and specificity. However, up to now the PSA test is still the only biomarker for the detection and monitoring of prostate cancer. PSA-based screening for prostate cancer is associated with a high proportion of unnecessary testing and overdiagnosis with subsequent overtreatment. In the early years of screening for prostate cancer, high rates of uptake were very important. However, over time the opinion on PSA-based screening has shifted towards the notion of informed choice. Nowadays, it is thought to be unethical to screen men without them being aware of the pros and cons of PSA testing, as well as the fact that an informed choice is related to better patient outcomes. Now, as the results of three major screening studies have been presented and the downsides of screening are becoming better understood, informed choice is becoming more relevant.

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Section: Active Surveillancementioning

confidence: 99%

Section: Active Surveillancementioning

confidence: 99%

Section: Active Surveillancementioning

confidence: 99%

Section: Active Surveillancementioning

confidence: 99%

See 2 more Smart Citations

PSA-based prostate cancer screening: the role of active surveillance and informed and shared decision making

Venderbos¹,

Roobol²

2011

Asian J Androl

View full text Add to dashboard Cite

show abstract

“…The first is the Japanese AS study that was carried out in favourable-risk PCa patients, starting in 2002. 13,14 The second is the PRIAS-JAPAN study (Japan has been participating in the PRIAS study as PRIAS-JAPAN since 2010). As of April 2012, 32 institutions had participated and approximately 250 patients were enrolled in the PRIAS-JAPAN study.…”

mentioning

confidence: 99%

Updated results from the European Randomized Study of Prostate-Specific Antigen (PSA) Screening for Prostate Cancer: are Asian countries encouraged to promote PSA screening?

Sugimoto¹,

Kakehi²

2012

Asian J Androl

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Active Surveillance for Low‐Risk Prostate Cancer

Klotz

2017

Management of Urologic Cancer

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Active surveillance for localized prostate cancer entails initial expectant management rather than immediate therapy, with "curative-intent" treatment deferred until there is evidence that the patient is at increased risk for disease progression. This is a response to the clearly documented risks of over diagnosis and overtreatment of low-risk prostate cancer, which in most cases poses little or no threat to the patient. It is based upon the prolonged natural history of prostate cancer and is an attempt to balance the risks and side effects of overtreatment against the possibility of disease progression and a lost opportunity for cure. Low-risk prostate cancer is more accurately viewed as one of multiple risk factors for the presence of higher grade prostate cancer. Like atypical small acinar proliferation, (ASAP), it may be managed with close follow up but without radical intervention, unless there is clear evidence of more aggressive disease.

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Prospective Evaluation of Selection Criteria for Active Surveillance in Japanese Patients with Stage T1cN0M0 Prostate Cancer

Abstract: The primary endpoint, '%PSADT > 2y', did not meet the pre-specified decision criteria. Further prospective study with revised program and endpoint is needed.

Cited by 71 publications

References 18 publications

PSA-based prostate cancer screening: the role of active surveillance and informed and shared decision making

PSA-based prostate cancer screening: the role of active surveillance and informed and shared decision making

Updated results from the European Randomized Study of Prostate-Specific Antigen (PSA) Screening for Prostate Cancer: are Asian countries encouraged to promote PSA screening?

Active Surveillance for Low‐Risk Prostate Cancer

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