Surveillance biopsy and active treatment during active surveillance for low-risk prostate cancer

Abstract

Surveillance biopsy is important for identifying patients who require active treatment. The results in this study allowed determination of the active treatment-free survival rate and are informative for making treatment decisions.

Disease-specific and patient-reported outcomes under active surveillance

“…The authors concluded that although there were differences with respect to active surveillance inclusion, surveillance, and discontinuation criteria between the two cohorts, the risk of deferred active therapy was equally moderate for both groups in the short-term follow-up [19]. Results from two small active surveillance cohorts in Japan [20] and Ireland [21] are in line with published outcomes of established active surveillance cohorts.…”

Systematic Review and Meta-analysis of Factors Determining Change to Radical Treatment in Active Surveillance for Localized Prostate Cancer

“…Up to an average of 38% of changes to radical treatments were because of a reclassified Gleason grade (95% CI 27%, 49%, Fig. 4) [14,17,19,[21][22][23]25,27,28,[33][34][35]. In the 17 studies References for the study settings are provided in Table 1.…”

“…detailing reasons, an average of 20% of treatment changes were because of patient choice or anxiety (95% CI 14%, 27%) [12,[14][15][16][17][18][19]22,23,[25][26][27]29,30,32,34,35].…”

“…The frequency of PSA testing, DRE, and rebiopsy during surveillance varied considerably across the studies. An increase in Gleason grade [12,[14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][32][33][34][35][36] was the most common trigger for recommendation of a change to radical treatment, followed by other pathological findings [12,14,16-24, 26,27,29,32-36], PSA or PSA kinetics [9,10,12,14,16,17,19,23,26,[28][29][30]32,34,35], and T stage [14,15,17,19,23,26].…”