Novel tools to improve patient selection and monitoring on active surveillance for low-risk prostate cancer: A systematic review

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Van Den Bergh R.C.N., Ahmed H.U., Bangma C.H., Cooperberg M.R., Villers A., Parker C.C.

European Urology 2014 65:6 (1023-1031)

Context Active surveillance (AS) is an alternative to initial radical treatment of low-risk prostate cancer (PCa). Current criteria for selection and follow-up incorrectly exclude some patients eligible for AS and misclassify some who actually harbour significant disease. Better prediction of cancer behaviour at diagnosis would allow less strict monitoring and may improve acceptance of AS. Objective To review and critically analyse the literature on the value of novel clinical tools for patient selection and monitoring on AS. Evidence acquisition A comprehensive search of the PubMed database until July 10, 2013, was performed according to Preferred Reporting Items for Systematic Reviews and Meta-analysis statement guidelines. Studies assessing novel markers and diagnostics for patient selection for AS and follow-up during AS were included. Studies analysing only classic clinical parameters used in current protocols ( prostate-specific antigen, prostate volume, number of (positive) prostate biopsies, percentage malignant tissue, Gleason score) were excluded. This review focuses only on the AS setting and not on predicting insignificant disease in general…(ver más)

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