A forthcoming paper in the Journal of Urology has suggested that active surveillance may be an acceptable option for selected patients with a clinical stage of ≤ T2a, a Gleason score of ≤ 6, but PSA levels of up to 20 ng/ml.
In the majority of currently used recommendations for enrollment of patients on to active surveillance protocols, the upper level for a patient’s PSA has been < 10 ng/ml. The outstanding exception to that general rule has been the Sunnybrook series of Klotz and his colleagues in Canada, which has routinely accepted patients with PSA levels up to 15 ng/ml.
Yu et al. have now reported data from a prospectively maintained database of men with histologically favorable-risk prostate cancer who all underwent radical prostatectomy between 2003 and 2015.
This was a retrospective study (which means that it needs to be evaluated with caution) in which they assigned all the…
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