Augustin Herbert, Mayerhofer Katrin, Seles Maximilian, Pummer Karl
Department of Urology, Medical University of Graz, Graz, Austria.
Urol Int. 2015;95(2):125-31. doi: 10.1159/000371895. Epub 2015 Mar 17.
Active surveillance (AS) represents an expectant treatment strategy for clinically localized prostate cancer (PCa) with low-risk features.
The actual management as well as the pros and cons of AS were evaluated.
A systematic review of the recent literature was performed using the Medline databases.
Since a substantial number of men die with rather than from PCa, there is a considerable role for AS in carefully selected men. AS may also represent a strategy to reduce the burden of overtreatment rooted in intensified PSA testing. Facing the imprecision of risk stratification based on transrectal ultrasound-guided biopsy, accurate clinical staging represents a major medical challenge. Counseling and care require empathy as well as a profound understanding of the biology and the natural history of PCa.
主动监测（AS）是针对具有低风险特征的临床局限性前列腺癌（PCa）的一种期待性治疗策略。
评估主动监测的实际管理情况及其利弊。
使用Medline数据库对近期文献进行系统综述。
由于相当数量的男性死于其他原因而非前列腺癌，因此主动监测在经过精心挑选的男性患者中具有重要作用。主动监测也可能是一种减轻因强化PSA检测导致的过度治疗负担的策略。鉴于经直肠超声引导活检进行风险分层存在不精确性，准确的临床分期是一项重大的医学挑战。咨询和护理需要同理心以及对前列腺癌生物学和自然史的深刻理解。
