Alam Ridwan, Carter H Ballentine, Epstein Jonathan I, Tosoian Jeffrey J
The James Buchanan Brady Urological Institute, Department of Urology, Johns Hopkins University School of MedicineBaltimore, MD.
Rev Urol. 2017;19(2):77-88. doi: 10.3909/riu0757a.
Active surveillance (AS) is an alternative to immediate intervention in patients with very low- and low-risk prostate cancer. Ongoing reports from multiple AS programs have consistently demonstrated a very low rate of metastasis and prostate cancerspecific mortality in appropriately selected patients. Accordingly, AS has been adopted by major clinical organizations as a safe and effective management strategy. Clinical focus has now shifted to identifying the optimal approach to selecting and monitoring patients. Multiparametric magnetic resonance imaging (mpMRI) has emerged as one potentially helpful tool in the AS setting. The utility of mpMRI has been well demonstrated in the setting of screening and diagnosis, but its role in AS remains unclear. We summarize the published experience with AS and review pertinent, contemporary data on the use of mpMRI in the setting of AS.
主动监测(AS)是极低和低风险前列腺癌患者立即干预的替代方案。多个主动监测项目的持续报告一致表明,在适当选择的患者中,转移率和前列腺癌特异性死亡率非常低。因此,主动监测已被主要临床组织采用为一种安全有效的管理策略。临床重点现已转向确定选择和监测患者的最佳方法。多参数磁共振成像(mpMRI)已成为主动监测环境中一种潜在有用的工具。mpMRI在筛查和诊断中的效用已得到充分证明,但其在主动监测中的作用仍不明确。我们总结了已发表的主动监测经验,并回顾了关于mpMRI在主动监测环境中使用的相关当代数据。