[Active surveillance for prostate cancer]
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[Active surveillance for prostate cancer]. / Graefen, Markus; Ahyai, Sascha; Heuer, Roman; Salomon, Georg; Schlomm, Thorsten; Isbarn, Hendrik; Budäus, Lars; Heinzer, Hans; Huland, Hartwig.
in: UROLOGE, Jahrgang 47, Nr. 3, 3, 2008, S. 261-269.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - [Active surveillance for prostate cancer]
AU - Graefen, Markus
AU - Ahyai, Sascha
AU - Heuer, Roman
AU - Salomon, Georg
AU - Schlomm, Thorsten
AU - Isbarn, Hendrik
AU - Budäus, Lars
AU - Heinzer, Hans
AU - Huland, Hartwig
PY - 2008
Y1 - 2008
N2 - Active surveillance is a valuable treatment option in patients with newly diagnosed low-risk prostate cancer. Studies considering a watchful waiting approach showed favourable cancer-specific survival rates in such patients and it is assumed that patients benefit from a definitive therapy if life expectancy exceeds 10-15 years. Therefore active surveillance is especially valuable in older men and in patients with an elevated comorbidity profile.Precise identification of histologically and clinically insignificant prostate cancers is still not possible today. Active surveillance includes regular PSA measurements combined with follow-up biopsies; however, no standardized protocol exists so far. Histological progression in the follow-up biopsy and PSA elevation are the most important criteria for initiating definitive therapy.Today only a minority of low-risk patients join an active surveillance protocol and a substantial proportion of these men leave such a protocol early without evidence of progression. The psychological burden of living with an untreated cancer seems to be responsible for this. Active surveillance has the potential to lead to undertreatment as there is some evidence that prolonged treatment delay might adversely affect outcome of definitive therapy.
AB - Active surveillance is a valuable treatment option in patients with newly diagnosed low-risk prostate cancer. Studies considering a watchful waiting approach showed favourable cancer-specific survival rates in such patients and it is assumed that patients benefit from a definitive therapy if life expectancy exceeds 10-15 years. Therefore active surveillance is especially valuable in older men and in patients with an elevated comorbidity profile.Precise identification of histologically and clinically insignificant prostate cancers is still not possible today. Active surveillance includes regular PSA measurements combined with follow-up biopsies; however, no standardized protocol exists so far. Histological progression in the follow-up biopsy and PSA elevation are the most important criteria for initiating definitive therapy.Today only a minority of low-risk patients join an active surveillance protocol and a substantial proportion of these men leave such a protocol early without evidence of progression. The psychological burden of living with an untreated cancer seems to be responsible for this. Active surveillance has the potential to lead to undertreatment as there is some evidence that prolonged treatment delay might adversely affect outcome of definitive therapy.
M3 - SCORING: Zeitschriftenaufsatz
VL - 47
SP - 261
EP - 269
JO - UROLOGE
JF - UROLOGE
SN - 0340-2592
IS - 3
M1 - 3
ER -