Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Radiation Oncology, University of Kansas Cancer Center, Kansas City, Kansas.
University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina.
Int J Radiat Oncol Biol Phys. 2021 Jul 1;110(3):712-715. doi: 10.1016/j.ijrobp.2021.01.014. Epub 2021 Jan 14.
Prospective clinical trials have demonstrated the safety and efficacy of active surveillance for men with localized prostate cancer but also suggested that inadequate surveillance may risk missing an opportunity for cure.
We used data from a population-based cohort of active-surveillance patients to examine the rigor of surveillance monitoring in the general population.
Among 1419 patients enrolled from 2011 to 2013 throughout the state of North Carolina in collaboration with the state cancer registry and followed prospectively, 346 pursued active surveillance. Only 13% received all guideline-recommended surveillance testing (including prostate-specific antigen, digital rectal examination, and prostate biopsy) within the first 2 years. Furthermore, adherence was <20% in all patient subgroups.
These findings suggest that "active surveillance" as implemented in the general population may not represent the rigorous monitoring regimens used in the studies that demonstrated the safety of this management approach. More real-world studies on active surveillance are needed.
前瞻性临床试验已经证明了主动监测对局限性前列腺癌患者的安全性和有效性，但也表明监测不足可能会错失治愈的机会。
我们利用来自一个基于人群的主动监测患者队列的数据，研究了在一般人群中监测监测的严格程度。
在 2011 年至 2013 年间，我们与州癌症登记处合作，在北卡罗来纳州全州范围内招募了 1419 名患者，并进行了前瞻性随访，其中 346 名患者进行了主动监测。只有 13%的患者在前 2 年内接受了所有指南推荐的监测检测（包括前列腺特异性抗原、直肠指检和前列腺活检）。此外，所有患者亚组的依从性均<20%。
这些发现表明，在一般人群中实施的“主动监测”可能并不代表在证明这种管理方法安全性的研究中使用的严格监测方案。需要更多关于主动监测的真实世界研究。
