Active surveillance as a practical strategy to differentiate lethal and non-lethal prostate cancer subtypes.
Active surveillance as a practical strategy to differentiate lethal and non-lethal prostate cancer subtypes.
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DOI：
10.1038/aja.2011.151
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发表时间：
2012-04
影响因子：
2.9
通讯作者：
Y. Kakehi
中科院分区：
文献类型：
--
作者：
Y. Kakehi
在前列腺特异性抗原（PSA）筛查使前列腺癌死亡率降低20%以上的时代，区分致死性和非致死性前列腺癌亚型已成为避免过度治疗的一个非常重要的问题。然而，在最初诊断时，很难确定哪些患者可以或不可以从立即治疗干预中获益。选择可以推迟立即治疗的候选患者，并通过特定的监测计划进行随访，或“主动监测”，是减少过度治疗的一种实用方法。在这篇综述中，讨论了主动监测的好处和风险。未来的前景，包括成像和新的生物标志物，以改善主动监测计划的结果，也进行了讨论。
Differentiation between lethal and non-lethal prostate cancer subtypes has become a very important issue in avoiding excessive treatment in an era when prostate-specific antigen (PSA) screening has reduced the rate of prostate cancer deaths by more than 20%. However, it is difficult to determine the patients who may or may not benefit from immediate treatment interventions at the time of the initial diagnosis. The selection of candidate patients who can postpone immediate treatment and undergo follow-ups with a specific surveillance program, or ‘active surveillance,' is a practical way to minimize overtreatment. In this review, the benefits and risks of active surveillance are discussed. Future perspectives, including imaging and new biomarkers for improving the outcomes of active surveillance programs, are also discussed.