Active surveillance for prostate cancer: a review.
Active surveillance for prostate cancer: a review.
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DOI：
10.1007/s11934-010-0110-z
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发表时间：
2010-05-01
影响因子：
2.6
通讯作者：
Klotz, Laurence
中科院分区：
文献类型：
--
作者：
Klotz, Laurence
主动监测是一个广泛承认的问题，过度诊断和过度治疗临床无关的疾病，伴随着前列腺癌的早期检测使用前列腺特异性抗原（PSA）和活检。这是一种管理有利风险前列腺癌的方法，它利用该疾病长期自然历史提供的机会，将一段时间的初步观察纳入患者管理。基本概念是，大多数被诊断为低级别、小体积疾病的男性在其一生中注定不会有任何临床表现。然而，一小部分有利风险前列腺癌患者存在风险，因为在诊断时存在不明显的高风险疾病，或者随着时间的推移发展为更具侵袭性的表型。这些患者可以通过密切随访，包括系列psa和活检，以合理的准确性识别，并在大多数情况下有效治疗。本文将回顾该方法的基本原理、患者选择、随访方法、干预的触发因素以及最近的结果。
Active surveillance is a solution to the widely acknowledged problem of overdiagnosis and overtreatment of clinically insignificant disease which accompanies early detection of prostate cancer using prostate-specific antigen (PSA) and biopsy. It is an approach to the management of favorable-risk prostate cancer which uses the opportunity provided by the long natural history of the disease to incorporate a period of initial observation into patient management. The basic concept is that most men diagnosed with low-grade, small-volume disease are not destined to have any clinical manifestations of the condition during their lifetime. However, a subset of patients with favorable-risk prostate cancer is at risk, due to either the presence of higher-risk disease not apparent at diagnosis or progression to a more aggressive phenotype over time. These patients can be identified with reasonable accuracy by close follow-up, including serial PSAs and biopsies, and treated effectively in most cases. The rationale, patient selection, method of follow-up, triggers for intervention, and recent results of this approach will be reviewed.