“Super” Active Surveillance

Treatment approaches for patients with localized low-risk prostate cancer who have a life expectancy greater than 10 years include radical prostatectomy, radiotherapy , active surveillance (AS), and focal ablative therapy . Since only about 3% of such patients experience disease progression or death, overtreatment is a concern and has led to increased use of active surveillance. However, AS can cause significant psychological stress for patients. To address this, a method called “Super” Active Surveillance (“Super” -AS) is proposed. Super-AS is an approach that combines advanced imaging techniques, such as 18F-PSMA PET/MR, with real-time intraoperative ultrasound to guide precise targeted cryoablation therapy.  This method aims to control tumors effectively while minimizing impacts on urinary and sexual function.  The authors claim that if focal therapy fails, subsequent radical prostatectomy does not compromise cancer control or increase complications.  Thus, “Super”-AS may serve as a transitional “bridge” between passive monitoring and radical treatment, offering a promising alternative for some patients.

PMID:41284628. DOI: 10.3791/68269