Lawrentschuk Nathan, Klotz Laurence
Department of Urology, University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Canada.
Korean J Urol. 2010 Oct;51(10):665-70. doi: 10.4111/kju.2010.51.10.665. Epub 2010 Oct 21.
Active surveillance is becoming a more widely accepted management strategy in men with low-risk localized prostate cancer. This is in recognition of the knowledge that most men with such cancer are likely to die from other causes. The obvious benefits of active surveillance are reduced morbidity by delaying or avoiding radical gland therapy. These advantages should be balanced against appropriate selection criteria and triggers for moving to radical therapy while on active surveillance. The optimal method by which to identify the small number of men who will progress by use of clinical, biopsy, and imaging data is yet to be defined. Nevertheless, active surveillance is an appealing management option in selected men with prostate cancer and represents a solution to the significant problem of the overdiagnosis of clinically insignificant disease that accompanies prostate-specific antigen (PSA) screening.
主动监测正成为低风险局限性前列腺癌男性患者中一种更广泛被接受的管理策略。这是基于这样一种认识：大多数患有此类癌症的男性可能死于其他原因。主动监测的明显益处是通过延迟或避免根治性腺体治疗来降低发病率。这些优势应与适当的选择标准以及在主动监测期间转向根治性治疗的触发因素相权衡。利用临床、活检和影像学数据来识别少数将会病情进展的男性的最佳方法尚未确定。尽管如此，主动监测对于选定的前列腺癌男性患者而言是一种有吸引力的管理选择，并且代表了一种解决伴随前列腺特异性抗原（PSA）筛查而来的临床意义不大疾病过度诊断这一重大问题的方法。
