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Review
. 2023 Oct;24(10):463-469.
doi: 10.1007/s11934-023-01177-2. Epub 2023 Jul 12.

Is Active Surveillance Too Active?

James T Kearns  1 , Brian T Helfand  2
Affiliations
Review

Is Active Surveillance Too Active?

James T Kearns et al. Curr Urol Rep. 2023 Oct.

Abstract

Purpose of review: Many prostate cancer active surveillance protocols mandate serial monitoring at defined intervals, including but certainly not limited to serum PSA (often every 6 months), clinic visits, prostate multiparametric MRI, and repeat prostate biopsies. The purpose of this article is to evaluate whether current protocols result in excessive testing of patients on active surveillance.

Recent findings: Multiple studies have been published in the past several years evaluating the utility of multiparametric MRI, serum biomarkers, and serial prostate biopsy for men on active surveillance. While MRI and serum biomarkers have promise with risk stratification, no studies have demonstrated that periodic prostate biopsy can be safely omitted in active surveillance. Active surveillance for prostate cancer is too active for some men with seemingly low-risk cancer. The use of multiple prostate MRIs or additional biomarkers do not always add to the prediction of higher-grade disease on surveillance biopsy.

Keywords: Active surveillance; Biomarkers; Prostate MRI; Prostate cancer.

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References

Papers of particular interest, published recently, have been highlighted as: •  Of importance •• Of major importance
    1. Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2022. CA A Cancer J Clin. 2022;72(1):7–33.
    1. Litwin MS, Hays RD, Fink A, Ganz PA, Leake B, Leach GE, et al. Quality-of-life outcomes in men treated for localized prostate cancer. JAMA. 1995;273(2):129–35. - DOI - PubMed
    1. Sanda MG, Dunn RL, Michalski J, Sandler HM, Northouse L, Hembroff L, et al. Quality of life and satisfaction with outcome among prostate-cancer survivors. N Engl J Med. 2008;358(12):1250–61. - DOI - PubMed
    1. Resnick MJ, Koyama T, Fan KH, Albertsen PC, Goodman M, Hamilton AS, et al. Long-term functional outcomes after treatment for localized prostate cancer. N Engl J Med. 2013;368(5):436–45. - DOI - PubMed - PMC
    1. •• Bill-Axelson A, Holmberg L, Garmo H, Taari K, Busch C, Nordling S, et al. Radical prostatectomy or watchful waiting in prostate cancer - 29-year follow-up. N Engl J Med. 2018 Dec 13;379(24):2319–29. This study remains the strongest evidence for treating clinically significant prostate cancer.

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