Magnetic Resonance Imaging in Active Surveillance of Prostate Cancer: A Systematic Review

Schoots, Ivo G.; Petrides, Neophytos; Giganti, Francesco; Bokhorst, Leonard P.; Rannikko, Antti; Klotz, Laurence; Villers, Arnauld; Hugosson, Jonas; Moore, Caroline M.

doi:10.1016/j.eururo.2014.10.050

Cited by 285 publications

(202 citation statements)

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“…Men with extraprostatic extension or lymphovascular invasion are exclusion criteria for AS [42]. Rebiopsy to exclude Gleason sampling error is considered important, [41] and mpMRI combined with targeted prostate biopsy demonstrated additional value in reclassification to high-grade PCa [43]. Its major role is furthermore based on its high NPV value for upgrading and to exclude anterior prostate lesions [43].…”

Section: Active Surveillance and Watchful Waitingmentioning

confidence: 99%

“…Rebiopsy to exclude Gleason sampling error is considered important, [41] and mpMRI combined with targeted prostate biopsy demonstrated additional value in reclassification to high-grade PCa [43]. Its major role is furthermore based on its high NPV value for upgrading and to exclude anterior prostate lesions [43]. Follow-up in AS is based on repeat biopsy, [41] serial PSA measurements and DRE, but the optimal schedule remains unclear.…”

Section: Active Surveillance and Watchful Waitingmentioning

confidence: 99%

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EAU-ESTRO-SIOG Guidelines on Prostate Cancer. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent

et al. 2017

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Section: Active Surveillance and Watchful Waitingmentioning

confidence: 99%

Section: Active Surveillance and Watchful Waitingmentioning

confidence: 99%

EAU-ESTRO-SIOG Guidelines on Prostate Cancer. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent

et al. 2017

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“…Also, one term (radiological progression) has been excluded from the AS dictionary because insufficient evidence exists to include it as yet. In a systematic review on the use of MRI in men with low-risk or intermediate-risk prostate cancer who were considered suitable for AS, MRI was demonstrated to be useful for the detection of clinically significant disease at initial clinical assessment of men considering AS 18 . In addition, MRI might be useful for confirming the absence of any large anterior lesions that could have been missed during routine diagnosis 19 .…”

Section: Strengths and Weaknessesmentioning

confidence: 99%

“…In addition, MRI might be useful for confirming the absence of any large anterior lesions that could have been missed during routine diagnosis 19 . However, robust, formally published data are needed before widespread implementation of MRI for this purpose 18,20 . Most likely, the semantics of AS will need to be augmented with MRI-related definitions as new evidence becomes available.…”

Section: Strengths and Weaknessesmentioning

confidence: 99%

Semantics in active surveillance for men with localized prostate cancer — results of a modified Delphi consensus procedure

et al. 2017

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| Active surveillance (AS) is broadly described as a management option for men with low-risk prostate cancer, but semantic heterogeneity exists in both the literature and in guidelines. To address this issue, a panel of leading prostate cancer specialists in the field of AS participated in a consensus-forming project using a modified Delphi method to reach international consensus on definitions of terms related to this management option. An iterative three-round sequence of online questionnaires designed to address 61 individual items was completed by each panel member. Consensus was considered to be reached if ≥70% of the experts agreed on a definition. To facilitate a common understanding among all experts involved and resolve potential ambiguities, a face-to-face consensus meeting was held between Delphi survey rounds two and three. Convenience sampling was used to construct the panel of experts. In total, 12 experts from Australia, France, Finland, Italy, the Netherlands, Japan, the UK, Canada and the USA participated. By the end of the Delphi process, formal consensus was achieved for 100% (n = 61) of the terms and a glossary was then developed. Agreement between international experts has been reached on relevant terms and subsequent definitions regarding AS for patients with localized prostate cancer. This standard terminology could support multidisciplinary communication, reduce the extent of variations in clinical practice and optimize clinical decision making.312 | MAY 2017 | VOLUME 14 www.nature.com/nrurol CONSENSUS STATEMENT © 2 0 1 7 M a c m i l l a n P u b l i s h e r s L i m i t e d , p a r t o f S p r i n g e r N a t u r e . A l l r i g h t s r e s e r v e d .degree of monitoring than those on AS might receive, and in which palliative treatment is generally instituted if metastases or local symptoms develop. Interpreting and comparing research results is difficult owing to the nonstandardized use of the terms AS and WW and their intended and often mixed treatment objectives (curative or palliative) 5 . This semantic heterogeneity is also reflected in AS guidelines 6 . In these guidelines, AS is primarily recommended for patients with low-risk tumours; however, these guidelines contain various definitions of low-risk prostate cancer, as specified by different combinations of clinical criteria including clinical and pathological characteristics (such as tumour stage, serum PSA levels, biopsy Gleason score, tumour volume and serum PSA density). Furthermore, definitions of disease reclassification and progression differ among published guidelines and multiple criteria for initiation of curative treatment are proposed 6 .Problems resulting from the use of ambiguous language include hindered clinical decision making, particularly in multidisciplinary collaborations, and limited opportunities for research 7 . Moreover, such ambiguity has raised a barrier that hampers exchange of knowledge within and between fundamental domains of research and research groups 8 . An urgent need exists for uniform...

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“…In summary, mpMRI could be useful in AS through (i) identifying men who would most benefit from additional biopsy (as presence of suspicious lesions on MRI predicts unfavorable histology [50]), (ii) increasing the diagnostic accuracy of prostate biopsy (as MRI-targeted biopsies in MRI-positive men increase the detection of significant cancers [51], outperform standard biopsies [52,53] and reduce misclassification [54]), (iii) reducing the number of biopsies needed to diagnose significant cancer [55] and the need for repeat biopsies [56] …”

Section: Mri In Active Surveillancementioning

confidence: 99%

When no treatment is the best treatment: Active surveillance strategies for low risk prostate cancers

Stavrinides

Parker

Moore

2017

Cancer Treatment Reviews

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Title:When no treatment is the best treatment: active surveillance strategies for low risk prostate cancers. Abstract:Although the incidence of prostate cancer is rising due to PSA screening and increased life expectancy, the metastatic potential of low-grade, organ-confined disease remainslow. An increasing number of studies suggest that radical treatment in such cases confers little or no survival benefit at a significant cost to morbidity. Active surveillance is a promising management approach of such low-risk cancers: eligible patients are selected based on clinical and pathological findings at diagnosis and are regularly monitored with digital rectal examinations, PSA testing and biopsies. Treatment, however, is deferred until and unless there is evidence of disease progression. This is a key difference from watchful waiting, where treatment is avoided until and unless there are symptoms. The purpose of this work is to review the rationale and evidence behind active surveillance and to offer an overview of current active surveillance strategies and outcomes.

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Magnetic Resonance Imaging in Active Surveillance of Prostate Cancer: A Systematic Review

Cited by 285 publications

References 29 publications

EAU-ESTRO-SIOG Guidelines on Prostate Cancer. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent

EAU-ESTRO-SIOG Guidelines on Prostate Cancer. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent

Semantics in active surveillance for men with localized prostate cancer — results of a modified Delphi consensus procedure

When no treatment is the best treatment: Active surveillance strategies for low risk prostate cancers

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