4.5 Review

Active Surveillance for Intermediate-risk Prostate Cancer: A Systematic Review, Meta-analysis, and Metaregression

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Summary: This qualitative systematic review explores the criteria for recruitment, monitoring, and reclassification in active surveillance protocols for localized prostate cancer. The study found that a minority of protocols included the use of MRI, and it recommends improvements in biopsy strategies for protocols without mandatory MRI use.

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Summary: Active surveillance may not be safe for patients with intermediate-risk prostate cancer, as it may increase the risk of metastasis and prostate cancer-specific mortality. However, carefully selected patients with favorable intermediate-risk prostate cancer may be suitable for active surveillance.

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Summary: While active surveillance (AS) is established for low-risk prostate cancer, its safety for intermediate-risk (IR) disease remains uncertain. Lack of randomized trials and limitations of observational studies call for further research to identify which IR prostate cancer patients can be safely managed with AS.

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