Téma: Overview works

Active surveillance of patients with an early prostate cancer

Michal Horňák, Vladimír Zvara

Objective: Following the introduction of PSA screening into clinical practice the incidence of small localized well differentiated prostate cancer has increased. Currently also this kind of cancer is treated by radical therapy quite often associated with significant complications. Alternative method is an active surveillance of patients: its aim is to individualize treatment procedures by opting for curative treatment only for patients with clinically significant prostate cancer. Methods: Based on searches from MEDLINE database and own experience the authors generated a summary of criteria selecting patients for active surveillance, method of monitoring patients during surveillance and indication of active curative treatment. Results: Criteria of patients’ selection for active surveillance modified throughout the years. In present days most often used criteria for selecting patients for active surveillance are: stage T1c and T2a, PSA ≤ 10.0 ng/ml, Gleason score ≤ 3 + 3 = 6, ≤ 2 positive cores at biopsy, the extent of cancer in any core (≤ 50 %). Indications for disease progression: PSA doubling time < 2 years or upgrading at repeat biopsy. Conclusion: Active surveillance offers individual approach to treatment procedures in early prostate cancer by selecting curative treatment only for patients with clinically significant prostate cancer. By increased use of PSA screening the incidence of prostate cancer indicated for active surveillance is expected to go up also in our setting. Introducing active surveillance in our conditions requires implementing procedures that will enable us to identify accurately and safely patients with clinically insignificant prostate cancer determined by PSA screening, and offer support to patients dealing with psychological strain of living with untreated cancer.

Ročník 2009  Témy časopisu Clinical urology 2 / 2009

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3. LIPID Study Group. Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. N Engl J Med 1998; 339: 1349-1357.
4. Jurkovičová O, Spitzerová H, Cagáň S. Komorové arytmie a náhla srdcová smrť pri akútnom infarkte myokardu. Bratisl Lek Listy 1997; 98: 379-389.
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Which of following factors is not related to rosacea?
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