Gleason pattern 4, Active Surveillance No More.

To reduce overtreatment of indolent prostate cancer (PCa), urologists have embraced active surveillance (AS) as a management strategy for low-risk PCa. However, patterns-of-care studies are now demonstrating that AS is also being utilized for patients with intermediate-risk disease.

A contemporary Australian study of 980 men reported that 8. 9% of intermediate-risk men were placed on AS of which 53. 8% had Gleason score (GS) 3+4 PCa and 10. 4% with 4+3 disease[1]. The most recent update from the CaPSURE database also reflected this trend in AS. However, questions remain about the safety of this practice, particularly as the majority of AS protocols worldwide exclude men with GS4 cancers unless their life expectancy is limited. This article is protected by copyright. All rights reserved.

BJU international. 2015 Sep 21 [Epub ahead of print]

Niranjan J Sathianathen, Declan G Murphy, Roderick C N van den Bergh, Nathan Lawrentchuk

Division of Cancer Surgery, University of Melbourne, Peter MacCallum Cancer Centre, Melbourne. , Division of Cancer Surgery, University of Melbourne, Peter MacCallum Cancer Centre, Melbourne. , Department of Urology, Royal Melbourne Hospital, Parkville, Melbourne, Australia. , Division of Cancer Surgery, University of Melbourne, Peter MacCallum Cancer Centre, Melbourne.

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