scholarly journals Biomarker in Active Surveillance for Prostate Cancer: A Systematic Review

Cancers ◽  
2021 ◽  
Vol 13 (17) ◽  
pp. 4251
Author(s):  
Cécile Manceau ◽  
Gaëlle Fromont ◽  
Jean-Baptiste Beauval ◽  
Eric Barret ◽  
Laurent Brureau ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Active Surveillance ◽  
Prospective Studies ◽  
Outcome Prediction ◽  
Invasive Procedures ◽  
Diagnosis And Prognosis ◽  
Long Term Follow Up ◽  
Monitoring Phase

Active surveillance (AS) in prostate cancer (PCa) represents a curative alternative for men with localised low-risk PCa. Continuous improvement of AS patient’s selection and surveillance modalities aims at reducing misclassification, simplifying modalities of surveillance and decreasing need for invasive procedures such repeated biopsies. Biomarkers represent interesting tools to evaluate PCa diagnosis and prognosis, of which many are readily available or under evaluation. The aim of this review is to investigate the biomarker performance for AS selection and patient outcome prediction. Blood, urinary and tissue biomarkers were studied and a brief description of use was proposed along with a summary of major findings. Biomarkers represent promising tools which could be part of a more tailored risk AS strategy aiming to offer personalized medicine and to individualize the treatment and monitoring of each patient. The usefulness of biomarkers has mainly been suggested for AS selection, whereas few studies have investigated their role during the monitoring phase. Randomized prospective studies dealing with imaging are needed as well as larger prospective studies with long-term follow-up and strong oncologic endpoints.

Gleason upgrading with time in a large, active surveillance cohort with long-term follow-up.

2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 1-1 ◽  
Author(s):  
Suneil Jain ◽  
Danny Vesprini ◽  
Alexandre Mamedov ◽  
D. Andrew Loblaw ◽  
Laurence Klotz
Keyword(s):  
Prostate Cancer ◽  
Active Surveillance ◽  
Linear Regression Analysis ◽  
Low Risk ◽  
Disease Rate ◽  
Intermediate Risk ◽  
Rate Of Increase ◽  
Long Term Follow Up

1 Background: Active surveillance (AS) is an accepted management strategy for localized prostate cancer. However, the rate of pathological upgrading has not been well described in mature study cohorts. Furthermore, concern exists over the possibility of prostate cancer dedifferentiation with time in patients on AS. Methods: Patients in our prospectively collected AS database with at least one repeat prostate biopsy were included. Linear regression analysis was used to estimate the proportion of patients upgraded (Gleason 6 to 3+4 or higher, Gleason 3+4 to 4+3 or higher) with time from diagnostic biopsy. Results: 593 of 862 patients in our cohort had at least one repeat biopsy. Median follow-up was 6.4 years (max. 20.2 years). The total number of biopsies ranged from 2 to 6. 20% of patients were intermediate risk, 0.3 % high risk, all others low risk. 31.2% of patients were upgraded during active surveillance. The proportion of patients upgraded increased with time, suggesting prostate cancer dedifferentiation occurred at a rate of 1.0%/year (95%CI -0.12 to 2.16%/year). The estimated rate of increase was 2.5 times higher in patients with intermediate risk disease at diagnosis (rate 1.9%/year, 95%CI -0.7-4.6) compared with those with low risk disease (rate 0.75%/year, 95%CI -0.5-2.0). Further analysis is underway. 62% of upgraded patients (n=114) went on to have active treatment. Patients who were upgraded and treated had significantly greater PSA velocities (median 1.2 ng/ml/y vs 0.42 ng/ml/y, p=0.01) and significantly higher Gleason scores when upgraded, than those who remained on surveillance (21.8% vs 2.8% Gleason 8-10, p<0.01). Conclusions: This is the largest re-biopsy cohort, with long-term follow-up, described to date, enabling the first estimates of prostate cancer dedifferentiation in patients on AS. Dedifferentiation rates appear higher in patients with intermediate risk prostate cancer compared with those who are low risk at baseline.

Pathological changes in patients with prostate cancer undergoing active surveillance in a long-term follow-up

2018 ◽  
Vol 17 (14) ◽  
pp. e2916-e2917
Author(s):  
G. Fernandez Conejo ◽  
V. Hernández Cañas ◽  
E. De La Peña Zarzuelo ◽  
A. Guijarro Cascales ◽  
M.D.M. Martínez Morales ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Active Surveillance ◽  
Pathological Changes ◽  
Long Term Follow Up

Clinical Results of Long-Term Follow-Up of a Large, Active Surveillance Cohort With Localized Prostate Cancer

2021 ◽  
pp. 25-30
Author(s):  
Niranjan Sathianathen
Keyword(s):  
Prostate Cancer ◽  
Active Surveillance ◽  
Local Treatment ◽  
Specific Antigen ◽  
Clinical Results ◽  
Curative Intent ◽  
Risk Prostate Cancer ◽  
Long Term Follow Up

This chapter provides a summary of an important observational study of men with clinically localized, mostly favorable-risk prostate cancer who were followed with active surveillance, which consisted of periodic prostate-specific antigen testing and repeat biopsies. It found that local treatment with curative intent can be safely deferred long term in many patients as long as they are carefully monitored.

scholarly journals Re: Long-term Follow-up of a Large Active Surveillance Cohort of Patients with Prostate Cancer

2015 ◽  
Vol 68 (5) ◽  
pp. 906-907 ◽  
Author(s):  
Yaw A. Nyame ◽  
Andrew J. Stephenson ◽  
Eric Klein
Keyword(s):  
Prostate Cancer ◽  
Active Surveillance ◽  
Long Term Follow Up

Prostate cancer adverse pathology reclassification in patients undergoing active surveillance in a long‐term follow‐up series

The Prostate ◽  
2019 ◽  
Vol 80 (2) ◽  
pp. 209-213
Author(s):  
Guillermo Fernández‐Conejo ◽  
Virginia Hernández ◽  
Ana Guijarro ◽  
Enrique Peña ◽  
Alberto Inés ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Active Surveillance ◽  
Long Term Follow Up
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