Role of active surveillance and focal therapy in low- and intermediate-risk prostate cancers
(2015) In World Journal of Urology 33(7). p.907-916- Abstract
Purpose: Low-risk prostate cancer is found in about half of newly diagnosed men subjected to PSA screening. Methods: To define the role of active surveillance and focal therapy in low- and intermediate-risk prostate cancers, an invited international panel of practicing physicians in the field of localized prostate cancer discussed the available literature in three consecutive meetings to come to a broad interpretation of the available data. Results: The panel (“new prostate cancer management group,” npm) agreed on the following observations. In most men with a low-volume Gleason 6 tumor, initial conservative management is appropriate. In men with a larger unifocal Gleason score 6 or 3 + 4 lesion, focal therapy, although still considered... (More)
Purpose: Low-risk prostate cancer is found in about half of newly diagnosed men subjected to PSA screening. Methods: To define the role of active surveillance and focal therapy in low- and intermediate-risk prostate cancers, an invited international panel of practicing physicians in the field of localized prostate cancer discussed the available literature in three consecutive meetings to come to a broad interpretation of the available data. Results: The panel (“new prostate cancer management group,” npm) agreed on the following observations. In most men with a low-volume Gleason 6 tumor, initial conservative management is appropriate. In men with a larger unifocal Gleason score 6 or 3 + 4 lesion, focal therapy, although still considered an investigational approach, appears to be a suitable option in early non-randomized comparison studies. Furthermore, in patients with multifocal small satellite Gleason 6 lesions in the presence of a larger index lesion, focal therapy of the index lesion is an option. For patients with high-grade, large-volume disease, or in young men with evidence of high-volume multifocal low-grade prostate cancer, whole-gland treatment should be considered. Conclusion: Active surveillance is a preferred and safe option for low-risk prostate cancer. Focal therapy is still under investigation, but the available phase II data are promising. Clinical benefits must be shown in prospective trials. With improved imaging, focal therapy may be an option for patients not choosing active surveillance with low-risk disease, progression upon active surveillance or intermediate-risk cancers with a localizable lesion.
(Less)
- author
- organization
- publishing date
- 2015-07-29
- type
- Contribution to journal
- publication status
- published
- keywords
- Active surveillance, Consensus, Focal therapy, Intermediate risk, Low risk, Prostate cancer
- in
- World Journal of Urology
- volume
- 33
- issue
- 7
- pages
- 907 - 916
- publisher
- Springer
- external identifiers
-
- scopus:84933179128
- pmid:26037891
- ISSN
- 0724-4983
- DOI
- 10.1007/s00345-015-1603-7
- language
- English
- LU publication?
- yes
- id
- 79b3da4b-d55d-470d-a953-fd12861448e5
- date added to LUP
- 2019-06-28 10:28:59
- date last changed
- 2024-04-02 12:44:50
@article{79b3da4b-d55d-470d-a953-fd12861448e5,
abstract = {{<p>Purpose: Low-risk prostate cancer is found in about half of newly diagnosed men subjected to PSA screening. Methods: To define the role of active surveillance and focal therapy in low- and intermediate-risk prostate cancers, an invited international panel of practicing physicians in the field of localized prostate cancer discussed the available literature in three consecutive meetings to come to a broad interpretation of the available data. Results: The panel (“new prostate cancer management group,” npm) agreed on the following observations. In most men with a low-volume Gleason 6 tumor, initial conservative management is appropriate. In men with a larger unifocal Gleason score 6 or 3 + 4 lesion, focal therapy, although still considered an investigational approach, appears to be a suitable option in early non-randomized comparison studies. Furthermore, in patients with multifocal small satellite Gleason 6 lesions in the presence of a larger index lesion, focal therapy of the index lesion is an option. For patients with high-grade, large-volume disease, or in young men with evidence of high-volume multifocal low-grade prostate cancer, whole-gland treatment should be considered. Conclusion: Active surveillance is a preferred and safe option for low-risk prostate cancer. Focal therapy is still under investigation, but the available phase II data are promising. Clinical benefits must be shown in prospective trials. With improved imaging, focal therapy may be an option for patients not choosing active surveillance with low-risk disease, progression upon active surveillance or intermediate-risk cancers with a localizable lesion.</p>}},
author = {{van der Poel, Henk and Klotz, Laurence and Andriole, Gerald and Azzouzi, Abdel Rahmène and Bjartell, Anders and Cussenot, Olivier and Hamdy, Freddy and Graefen, Markus and Palma, Paolo and Rivera, Arturo Rodriguez and Stief, Christian G.}},
issn = {{0724-4983}},
keywords = {{Active surveillance; Consensus; Focal therapy; Intermediate risk; Low risk; Prostate cancer}},
language = {{eng}},
month = {{07}},
number = {{7}},
pages = {{907--916}},
publisher = {{Springer}},
series = {{World Journal of Urology}},
title = {{Role of active surveillance and focal therapy in low- and intermediate-risk prostate cancers}},
url = {{http://dx.doi.org/10.1007/s00345-015-1603-7}},
doi = {{10.1007/s00345-015-1603-7}},
volume = {{33}},
year = {{2015}},
}