Institute of Pathological Anatomy and Histopathology, School of Medicine, Polytechnic University of the Marche Region, United Hospitals, Via Conca 71, Torrette, Ancona, Italy.
Acta Oncol. 2011 Jun;50 Suppl 1:56-60. doi: 10.3109/0284186X.2010.522199.
Surgery or radiation therapy remain the standard curative treatments for newly diagnosed prostate cancer patients. Nonetheless, these aggressive treatments are associated with decreased quality of life with altered sexual and urinary functions. The objective was a systematic review of active surveillance protocols to investigate the role of histopathology and molecular markers in the active surveillance of prostate cancer. Medline was searched using the following terms: prostate cancer, active surveillance and expectant management. Selection criteria, follow-up strategies and outcomes. Using modern risk stratification, several centres have gained significant experience in identifying patients with a low risk of prostate cancer progression and have adopted an active surveillance program with delayed curative therapy. Interestingly, only limited numbers of patients under active surveillance require additional treatment. Recent data suggest that delayed treatment does not appear to alter the clinical outcome among those highly selected patients. The future and conclusions. A better understanding of the molecular determinants of prostate cancer behaviour would not only enable healthcare professionals to identify which cases need aggressive treatment but, perhaps more importantly, would also indicate potential targets for the development of novel therapeutic strategies.
手术或放疗仍然是新诊断前列腺癌患者的标准治疗方法。然而，这些激进的治疗方法与改变的性功能和泌尿系统功能相关的生活质量下降有关。本研究的目的是对主动监测方案进行系统回顾，以探讨组织病理学和分子标志物在前列腺癌主动监测中的作用。使用以下术语在 Medline 中进行检索：前列腺癌、主动监测和期待治疗。选择标准、随访策略和结果。利用现代风险分层，一些中心在识别前列腺癌进展风险较低的患者方面积累了丰富的经验，并采用了主动监测方案，延迟了根治性治疗。有趣的是，只有少数接受主动监测的患者需要额外的治疗。最近的数据表明，延迟治疗似乎不会改变这些高度选择的患者的临床结果。未来和结论。更好地了解前列腺癌行为的分子决定因素，不仅可以使医疗保健专业人员能够识别哪些病例需要积极治疗，而且更重要的是，还可以为开发新的治疗策略指明潜在的靶点。
