[Management of low-risk prostate cancer]

Prog Urol. 2015 Jan;25(1):1-10. doi: 10.1016/j.purol.2014.10.007. Epub 2014 Nov 20.
[Article in French]

Abstract

Introduction: The widespread use of prostate cancer screening has led to a stage migration resulting in an increase in the diagnosis of low-risk disease, which currently accounts for 40-50% of diagnosed forms. New therapeutic strategies have been developed in order to minimize the risk of overtreatment.

Methods: A systematic review of the literature over the past 20 years was performed using the Medline database. The literature selection was based on evidence and practical considerations.

Results: Low-risk tumors are conventionally defined by the d'Amico classification. The use of multiparametric MRI helps to better characterize these tumors. The contribution of molecular biology remains to be determined in clinical practice. Novel therapeutic options for low-risk disease are currently being evaluated.

Conclusion: The new therapeutic strategies are evolving. They seek to reduce overtreatment without compromising oncological success.

Keywords: Active surveillance; Cancer de la prostate à faible risque; Focal therapy; Low-risk prostate cancer; Prostatectomie totale; Radiation therapy; Radical prostatectomy; Radiothérapie; Surveillance active; Traitement focal.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Disease Progression
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Patient Selection
  • Prostate-Specific Antigen
  • Prostatectomy
  • Prostatic Neoplasms / classification*
  • Prostatic Neoplasms / pathology
  • Prostatic Neoplasms / therapy*
  • Secondary Prevention
  • Watchful Waiting

Substances

  • Prostate-Specific Antigen