Active surveillance for the management of localized prostate cancer: Guideline recommendations
Active surveillance for the management of localized prostate cancer: Guideline recommendations
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DOI：
10.5489/cuaj.2806
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发表时间：
2015-06-01
影响因子：
1.9
通讯作者：
Evans, Andrew
中科院分区：
文献类型：
--
作者：
Morash, Chris;Tey, Rovena;Evans, Andrew
导言：目的是就主动监测(AS)作为低风险前列腺癌患者的管理策略的作用提供指导，并确保通过标准化方案评估适当的AS患者。前列腺癌通常是一种进展缓慢或有时不进展的惰性疾病，在早期诊断为局部肿瘤，不太可能导致发病率或死亡。前列腺癌的标准积极治疗方法包括放射治疗(RT)或根治性前列腺癌切除术(RP)，但过度诊断和过度治疗带来的危害令人担忧。AS越来越被认为是避免或延迟不必要的根治性治疗所造成的潜在危害的管理策略。方法：对MEDLINE、EMBASE、Cochrane图书馆、指南数据库和相关会议记录进行文献检索，并对已确定的证据进行系统综述，以提出与AS在局限性前列腺癌治疗中的作用相关的建议。结果：现有的指南或综述不适合用于综合证据，但确定了59篇初步研究报告。由于研究的非比较性或异质性，没有进行合并荟萃分析。结论：工作组的结论是，对于低风险(Gleason评分)的患者
Introduction: The objective is to provide guidance on the role of active surveillance (AS) as a management strategy for low-risk prostate cancer patients and to ensure that AS is offered to appropriate patients assessed by a standardized protocol. Prostate cancer is often a slowly progressive or sometimes non-progressive indolent disease diagnosed at an early stage with localized tumours that are unlikely to cause morbidity or death. Standard active treatments for prostate cancer include radiotherapy (RT) or radical prostatectomy (RP), but the harms from over diagnosis and overtreatment are of a significant concern. AS is increasingly being considered as a management strategy to avoid or delay the potential harms caused by unnecessary radical treatment.Methods: A literature search of MEDLINE, EMBASE, the Cochrane library, guideline databases and relevant meeting proceedings was performed and a systematic review of identified evidence was synthesized to make recommendations relating to the role of AS in the management of localized prostate cancer.Results: No exiting guidelines or reviews were suitable for use in the synthesis of evidence for the recommendations, but 59 reports of primary studies were identified. Due to studies being either non-comparative or heterogeneous, pooled meta-analyses were not conducted.Conclusion: The working group concluded that for patients with low-risk (Gleason score