Department of Molecular Pharmacology and Therapeutics, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, 10032, USA.
Department of Molecular Pharmacology and Therapeutics, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, 10032, USA; Department of Urology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, 10032, USA; Department of Systems Biology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, 10032, USA; Department of Pathology & Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, 10032, USA; Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, 10032, USA; Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY, 10032, USA.
Cancer Lett. 2022 Jul 10;538:215709. doi: 10.1016/j.canlet.2022.215709. Epub 2022 Apr 29.
The vast majority of new prostate cancer diagnoses are low-grade tumors that are monitored by active surveillance rather than undergoing immediate treatment. However, a subset of men will progress to advanced prostate cancer which may result in lethality, and these men are likely to benefit from early intervention to prevent or delay such progression. For this high-risk group, which includes aged men, men of African descent, and those with a hereditary predisposition to prostate cancer, informed risk stratification can be the cornerstone of clinical decision making and treatment intervention. In this review, we discuss the importance of a precision intervention approach that considers the cumulative risk for a given patient or population to develop prostate cancer or to progress to lethal disease, with particular focus on the interplay of major determinants of high-risk disease.
绝大多数新诊断的前列腺癌为低级别肿瘤，通过主动监测而非立即治疗进行监测。然而，有一部分男性的前列腺癌会进展为晚期，这可能导致致命后果，这些男性可能受益于早期干预以预防或延迟这种进展。对于这一高危人群，包括老年男性、非洲裔男性以及有遗传性前列腺癌倾向的男性，进行个体化风险分层是临床决策和治疗干预的基石。在这篇综述中，我们讨论了精准干预方法的重要性，该方法需要考虑特定患者或人群发生前列腺癌或进展为致命疾病的累积风险，特别关注高危疾病的主要决定因素之间的相互作用。
