Leinwand Gabriel Z, Gabrielson Andrew T, Krane Louis S, Silberstein Jonathan L
Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA.
Transl Androl Urol. 2018 Sep;7(Suppl 4):S397-S410. doi: 10.21037/tau.2018.06.19.
Active surveillance (AS) is a treatment modality for prostate cancer that aims to simultaneously avoid overtreatment and allow for the timely intervention of localized disease. AS has become the de facto standard of care for most men with low-risk prostate cancer. However, few African American (AA) men were included in the prospective observational cohorts that resulted in a paradigm shift in treatment recommendations from active intervention toward AS. It has been established that AA men have an increased prostate cancer incidence, higher baseline prostate-specific antigen (PSA) values, more aggressive prostate cancer features, greater frequency of biochemical recurrence after treatment, and higher overall cancer-specific mortality compared to their Caucasian counterparts. As such, this has given many physicians pause before initiating AS for AA patients. In the following manuscript, we will review the available literature regarding AS, with a particular focus on AA men. The preponderance of evidence demonstrates that AS is as viable a management method for AA with low-risk prostate cancer as it is with other racial groups.
主动监测（AS）是一种针对前列腺癌的治疗方式，旨在同时避免过度治疗，并允许对局限性疾病进行及时干预。AS已成为大多数低风险前列腺癌男性事实上的标准治疗方法。然而，很少有非裔美国（AA）男性被纳入前瞻性观察队列，而正是这些队列导致了治疗建议从积极干预向AS的范式转变。已经证实，与白人男性相比，AA男性前列腺癌发病率更高、基线前列腺特异性抗原（PSA）值更高、前列腺癌特征更具侵袭性、治疗后生化复发频率更高以及总体癌症特异性死亡率更高。因此，这使得许多医生在为AA患者启动AS之前有所顾虑。在以下手稿中，我们将回顾关于AS的现有文献，特别关注AA男性。大量证据表明，AS对于低风险前列腺癌的AA男性来说，是一种与其他种族群体同样可行的管理方法。
