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- W2108380963 abstract "No AccessJournal of UrologyReview article1 Aug 2006Continuing Controversy Over Monitoring Men With Localized Prostate Cancer: A Systematic Review of Programs in the Prostate Specific Antigen Era Richard M. Martin, David Gunnell, Freddie Hamdy, David Neal, Athene Lane, and Jenny Donovan Richard M. MartinRichard M. Martin Department of Social Medicine, University of Bristol, Bristol More articles by this author , David GunnellDavid Gunnell Department of Social Medicine, University of Bristol, Bristol More articles by this author , Freddie HamdyFreddie Hamdy Division of Clinical Sciences (South), University of Sheffield, Sheffield More articles by this author , David NealDavid Neal Oncology Centre, University of Cambridge, Cambridge, United Kingdom Financial interest and/or other relationship with GlaxoSmithKline and AstraZeneca. More articles by this author , Athene LaneAthene Lane Department of Social Medicine, University of Bristol, Bristol More articles by this author , and Jenny DonovanJenny Donovan Department of Social Medicine, University of Bristol, Bristol More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2006.03.030AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: There is continuing controversy over the most appropriate treatment for screen detected and clinically localized prostate cancer, and increasing interest in monitoring such men initially with radical treatment targeted at cancers showing signs of progressive potential but while they are still curable. Current evidence on monitoring protocols and biomarkers used to predict disease progression was systematically reviewed. Materials and Methods: The MEDLINE and Excerpta Medica (EMBASE) bibliographic databases were searched from 1988 to October 2004, supplemented by manual searches of reference lists, focusing on studies reporting monitoring of men with localized prostate cancer. Results: A total of 48 potentially eligible articles were found but only 5 studies, in which there was a total of 451 participants, restricted entry criteria to men with clinically localized (T1-T2) prostate cancer. Monitoring protocols varied with little consensus, although the majority used prostate specific antigen and digital rectal examination, while some added re-biopsy to assess progression. Actuarial probabilities of freedom from disease progression at 4 to 5 years of followup were 67% to 72%. However, up to 50% of men abandoned monitoring within 2 years, largely because of anxiety related to increasing prostate specific antigen rather than objective evidence of disease progression. There was no robust evidence to support prostate specific antigen doubling times or velocity to identify men in whom disease may progress. Studies were characterized by small sample size, short-term followup, observer bias and uncertain validity around variable definitions of progression. Conclusions: Current evidence suggests that some form of monitoring would be a suitable treatment option in men with localized prostate cancer but there is little consensus over what markers should be used in such a program or how progression should be properly defined. The search for a method that safely identifies men with prostate cancer who could avoid radical intervention must continue. References 1 : Cancer burden in the year 2000. The global picture. Eur J Cancer2001; 37: 4. Google Scholar 2 : Localised prostatic cancer: management and detection issues. Lancet1994; 343: 1263. Google Scholar 3 : Progress toward identifying aggressive prostate cancer. N Engl J Med2004; 351: 180. 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Google Scholar © 2006 by American Urological AssociationFiguresReferencesRelatedDetailsCited byLoo R, Shapiro C, Tamaddon K, Chien G, Rhee E and Jacobsen S (2018) The Continuum of Prostate Cancer Care: An Integrated Population Based Model of Health Care DeliveryUrology Practice, VOL. 2, NO. 2, (78-84), Online publication date: 1-Mar-2015.Martin R and Donovan J (2018) Editorial CommentJournal of Urology, VOL. 180, NO. 4, (1340-1341), Online publication date: 1-Oct-2008.Griffin C, Yu X, Loeb S, Desireddi V, Han M, Graif T and Catalona W (2018) Pathological Features After Radical Prostatectomy in Potential Candidates for Active MonitoringJournal of Urology, VOL. 178, NO. 3, (860-863), Online publication date: 1-Sep-2007.Venkitaraman R, Norman A, Woode-Amissah R, Fisher C, Dearnaley D, Horwich A, Huddart R, Khoo V, Thompson A and Parker C (2018) Predictors of Histological Disease Progression in Untreated, Localized Prostate CancerJournal of Urology, VOL. 178, NO. 3, (833-837), Online publication date: 1-Sep-2007. Volume 176Issue 2August 2006Page: 439-449 Advertisement Copyright & Permissions© 2006 by American Urological AssociationKeywordsdisease progressionprognosisprostatic neoplasmsprostateprostate-specific antigenMetricsAuthor Information Richard M. Martin Department of Social Medicine, University of Bristol, Bristol More articles by this author David Gunnell Department of Social Medicine, University of Bristol, Bristol More articles by this author Freddie Hamdy Division of Clinical Sciences (South), University of Sheffield, Sheffield More articles by this author David Neal Oncology Centre, University of Cambridge, Cambridge, United Kingdom Financial interest and/or other relationship with GlaxoSmithKline and AstraZeneca. More articles by this author Athene Lane Department of Social Medicine, University of Bristol, Bristol More articles by this author Jenny Donovan Department of Social Medicine, University of Bristol, Bristol More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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