Active surveillance should be considered for select men with Grade Group 2 prostate cancer

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Pekala, Kelly R.Mem Sloan Kettering Canc Ctr, Dept Surg Urol Serv, 1133 York Ave, New York, NY 10065 USA. (författare)

Active surveillance should be considered for select men with Grade Group 2 prostate cancer

Artikel/kapitelEngelska2023

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BioMed Central (BMC),2023
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LIBRIS-ID:oai:DiVA.org:uu-515657
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-515657URI
https://doi.org/10.1186/s12894-023-01314-6DOI

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BackgroundTreatment decisions for localized prostate cancer must balance patient preferences, oncologic risk, and preservation of sexual, urinary and bowel function. While Active Surveillance (AS) is the recommended option for men with Grade Group 1 (Gleason Score 3 + 3 = 6) prostate cancer without other intermediate-risk features, men with Grade Group 2 (Gleason Score 3 + 4 = 7) are typically recommended active treatment. For select patients, AS can be a possible initial management strategy for men with Grade Group 2. Herein, we review current urology guidelines and the urologic literature regarding recommendations and evidence for AS for this patient group.Main bodyAS benefits men with prostate cancer by maintaining their current quality of life and avoiding treatment side effects. AS protocols with close follow up always allow for an option to change course and pursue curative treatment. All the major guideline organizations now include Grade Group 2 disease with slightly differing definitions of eligibility based on risk using prostate-specific antigen (PSA) level, Gleason score, clinical stage, and other factors. Selected men with Grade Group 2 on AS have similar rates of deferred treatment and metastasis to men with Grade Group 1 on AS. There is a growing body of evidence from randomized controlled trials, large observational (prospective and retrospective) cohorts that confirm the oncologic safety of AS for these men. While some men will inevitably conclude AS at some point due to clinical reclassification with biopsy or imaging, some men may be able to stay on AS until transition to watchful waiting (WW). Magnetic resonance imaging is an important tool to confirm AS eligibility, to monitor progression and guide prostate biopsy.ConclusionAS is a viable initial management option for well-informed and select men with Grade Group 2 prostate cancer, low volume of pattern 4, and no other adverse clinicopathologic findings following a well-defined monitoring protocol. In the modern era of AS, urologists have tools at their disposal to better stage patients at initial diagnosis, risk stratify patients, and gain information on the biologic potential of a patient’s prostate cancer.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Urologi och njurmedicin hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Urology and Nephrology hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Cancer och onkologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cancer and Oncology hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kirurgi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Surgery hsv//eng
Prostate cancer
Active surveillance
Grade group 2

Biuppslag (personer, institutioner, konferenser, titlar ...)

Bergengren, OskarUppsala universitet,Urologkirurgi,Mem Sloan Kettering Canc Ctr, Dept Surg Urol Serv, 1133 York Ave, New York, NY 10065 USA(Swepub:uu)oskka588 (författare)
Eastham, James A.Mem Sloan Kettering Canc Ctr, Dept Surg Urol Serv, 1133 York Ave, New York, NY 10065 USA. (författare)
Carlsson, Sigrid V.Mem Sloan Kettering Canc Ctr, Dept Surg Urol Serv, 1133 York Ave, New York, NY 10065 USA.;Mem Sloan Kettering Canc Ctr, Dept Epidemiol & Biostat, New York, NY 10065 USA.;Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Dept Urol, Gothenburg, Sweden. (författare)
Mem Sloan Kettering Canc Ctr, Dept Surg Urol Serv, 1133 York Ave, New York, NY 10065 USA.Urologkirurgi (creator_code:org_t)

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Ingår i:BMC Urology: BioMed Central (BMC)23:11471-2490

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Av författaren/redakt...: Pekala, Kelly R.; Bergengren, Oska ...; Eastham, James A ...; Carlsson, Sigrid ...

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Urologi och njur ...

MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Cancer och onkol ...

MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Kirurgi

Artiklar i publikationen: BMC Urology

Av lärosätet: Uppsala universitet

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