Active surveillance (AS) is an established approach in the management of low-risk, localized prostate cancer. While the use of AS to manage intermediate-risk (IR) disease has gradually increased over time, there remains uncertainty with regards to its safety, with only a minority of IR patients currently being managed with this approach.
We conducted a narrative review based on an analysis of the literature focusing on articles describing AS for IR prostate cancer. We focus on the uncertainty surrounding AS in IR disease by discussing variations in the definitions and guideline recommendations associated with IR disease, and describing the limitations of the evidence from observational studies and randomized trials.
The safety of AS for IR disease remains unknown, given the lack of randomized trials and the limitations of the current observational studies. Further research is needed to identify select patients with IR prostate cancer that can be managed safely with AS.
World journal of urology. 2022 Jan 19 [Epub ahead of print]
Madhur Nayan, Filipe L F Carvalho, Adam S Feldman
Department of Urology, Massachusetts General Hospital, 55 Fruit St, GRB 1100, Boston, MA, 02114, USA., Department of Urology, Massachusetts General Hospital, 55 Fruit St, GRB 1100, Boston, MA, 02114, USA. .