Long-Term Active Surveillance for Prostate Cancer: Answers and Questions
Menée sur 993 patients atteints d'un cancer de la prostate à pronostic favorable ou à risque intermédiaire de récidive (durée médiane de suivi après la première biopsie : 6,4 ans), cette étude évalue, du point de vue des taux actuariels de survie spécifique et des taux de mortalité à 5, 10 ou 15 ans, la possibilité de mettre en place une surveillance médicale active
In recent years, active surveillance has evolved from an experimental protocol to a broadly accepted—in fact, preferred—management strategy for men diagnosed with low-risk prostate cancer. Active surveillance is a crucial aspect of efforts to solve the prostate-specific antigen (PSA) –based early detection conundrum without sacrificing the tremendous gains that have been realized in mortality rates. Cohort studies of active surveillance, primarily from academic institutions, have collectively reported short- to intermediate-term outcomes on thousands of men, generally supporting the safety and efficacy of the approach over the first years of follow-up. This conservative approach to low-risk disease appears to be making recent inroads even outside of academia, at least in limited settings. The problem has been that the natural history of low-risk prostate cancer is measurable over years and decades, and short-term disease stability does not reliably predict long-term survival.
Journal of Clinical Oncology , éditorial en libre accès, 2014