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Active surveillance

All articles from this key word are listed below.

Volume 14, Number 1 Meeting Reviews

Innovation in Endourology and Minimally Invasive Surgery

Highlights From the 29th World Congress of Endourology and SWL 2011, November 30-December 3, 2011, Kyoto, Japan

James F Borin Stacy Loeb

[ Rev Urol. 2012;14(1/2):28-30 doi: 10.3909/riu0554] © 2012 MedReviews®, LLC

Percutaneous nephrolithotomy Small renal mass Active surveillance Endourology

Volume 14, Number 1 Review Articles

Active Surveillance for Small Renal Masses

Management Update

Jeffrey K Mullins Mohamad E Allaf Elias S Hyams Phillip M Pierorazio

Small renal masses (SRMs; # 4 cm in dimension) have rapidly risen in incidence in recent decades and pose an increasingly common management dilemma in urology. SRMs are biologically heterogeneous and a wide variety of treatments exist with favorable oncologic outcomes. Active surveillance (AS) has emerged as a viable option for those not desiring surgery or those who are suboptimal candidates for surgery, with < 2% of patients progressing to metastatic disease in retrospective and prospective studies. This article reviews the current data regarding AS for SRM, operational considerations for an AS program, and criteria for safely selecting patients for this treatment strategy. [ Rev Urol. 2012;14(1/2):13-19 doi: 10.3909/riu0545] © 2012 MedReviews®, LLC

Renal cell carcinoma Small renal mass Active surveillance

Volume 15, Number 4 Meeting Reviews

Updates in the Care and Management of Prostate Cancer: Highlights From the 2013 Prostate Cancer World Congress, August 6-10, 2013, Melbourne, Australia

Áine Goggins Marnique Basto Stacy Loeb

[Rev Urol. 2013;15(4):185-187 doi: 10.3909/riu0599] © 2014 MedReviews®, LLC

Prostate cancer Active surveillance Health disparities Consensus statement

Volume 18, Number 3 Meeting Reviews

Highlights From the 2016 American Urological Association Annual Meeting

Michael A Gorin J Curtis Nickel Michael K Brawer Michael B Chancellor Dean G Assimos Ellen Shapiro Alan W Partin Benjamin M Brucker Stacy Loeb

More than 2000 posters, abstracts, and videos were presented at the 2016 American Urological Association (AUA) Annual Meeting, held in San Diego, CA, from May 6 to 10, 2016. The editors of Reviews in Urology have culled an enormous volume of information from this premier source and present the findings that are most relevant to the practicing urologist. [Rev Urol. 2016;18(3):159-173 doi:10.3909/riu0717] © 2016 MedReviews®, LLC

Prostate cancer Active surveillance Disorders of sexual development Nephrolithiasis Overactive bladder Microbiome OnabotulinumtoxinA Hemorrhagic cystitis Inflammation Four kallikrein assay Genomic prostate score

Volume 19, Number 2 Review Articles

Active Surveillance of Prostate Cancer: Current State of Practice and Utility of Multiparametric Magnetic Resonance Imaging

Practice Update

H Ballentine Carter Jonathan I Epstein Ridwan Alam Jeffrey J Tosoian

Active surveillance (AS) is an alternative to immediate intervention in patients with very low- and low-risk prostate cancer. Ongoing reports from multiple AS programs have consistently demonstrated a very low rate of metastasis and prostate cancer-specific mortality in appropriately selected patients. Accordingly, AS has been adopted by major clinical organizations as a safe and effective management strategy. Clinical focus has now shifted to identifying the optimal approach to selecting and monitoring patients. Multiparametric magnetic resonance imaging (mpMRI) has emerged as one potentially helpful tool in the AS setting. The utility of mpMRI has been well demonstrated in the setting of screening and diagnosis, but its role in AS remains unclear. We summarize the published experience with AS and review pertinent, contemporary data on the use of mpMRI in the setting of AS. [Rev Urol. 2017;19(2):77–88 doi: 10.3909/riu0757] © 2017 MedReviews®, LLC

Prostate cancer Active surveillance Multiparametric magnetic resonance imaging

Volume 19, Number 4 Review Articles

Active Surveillance Use Among a Low-risk Prostate Cancer Population in a Large US Payer System: 17-Gene Genomic Prostate Score Versus Other Risk Stratification Methods

Original Research

Steven Canfield John Hornberger Phillip G Febbo Michael J Kemeter

Many men with low-risk prostate cancer (PCa) receive definitive treatment despite recommendations that have been informed by two large, randomized trials encouraging active surveillance (AS). We conducted a retrospective cohort study using the Optum™ Research Database (Eden Prairie, MN) of electronic health records and administrative claims data to assess AS use for patients tested with a 17-gene Genomic Prostate Score™ (GPS; Genomic Health, Redwood City, CA) assay and/or prostate magnetic resonance imaging (MRI). De-identified records were extracted on health plan members enrolled from June 2013 to June 2016 who had ≥1 record of PCa (n = 291,876). Inclusion criteria included age ≥18 years, new diagnosis, American Urological Association low-risk PCa (stage T1-T2a, prostate-specific antigen ≥10 ng/mL, Gleason score = 6), and clinical activity for at least 12 months before and after diagnosis. Data included baseline characteristics, use of GPS testing and/or MRI, and definitive procedures. GPS or MRI testing was performed in 17% of men (GPS, n = 375, 4%; MRI, n = 1174, 13%). AS use varied from a low of 43% for men who only underwent MRI to 89% for GPS-tested men who did not undergo MRI (P<001). At 6-month follow-up, AS use was 31.0% higher (95% CI, 27.6%-34.5%; P<001) for men receiving the GPS test only versus men who did not undergo GPS testing or MRI; the difference was 30.5% at 12-month follow-up. In a large US payer system, the GPS assay was associated with significantly higher AS use at 6 and 12 months compared with men who had MRI only, or no GPS or MRI testing. [Rev Urol. 2017;19(4):203–212 doi: 10.3909/riu0786] © 2018 MedReviews®, LLC

Prostate cancer Active surveillance Evidence-based practice Comparative effectiveness research Genomic biomarker Magnetic resonance imaging

Volume 20, Number 2 Meeting Reviews

Highlights From the 2018 American Urological Association Annual Meeting, May 18-21, 2018, San Francisco, CA

Best of the 2018 AUA Annual Meeting

Alan W Partin Zeyad R Schwen

[Rev Urol. 2018;20(2):98–100 doi: 10.3909/riu0806] © 2018 MedReviews®, LLC

Prostate cancer Risk stratification Active surveillance mpMRI

Volume 20, Number 2 Original Research

Balancing Confounding and Generalizability Using Observational, Real-world Data: 17-gene Genomic Prostate Score Assay Effect on Active Surveillance

Steven Canfield John Hornberger Michael J Kemeter Phillip G Febbo

Randomized, controlled trials can provide high-quality, unbiased evidence for therapeutic interventions but are not always a practical or viable study design for certain healthcare decisions, such as those involving prognostic or predictive testing. Studies using large, real-world databases may be more appropriate and more generalizable to the intended target population of physicians and patients to answer these questions but carry potential for hidden bias. We illustrate several emerging methods of analyzing observational studies using propensity score matching (PSM) and coarsened exact matching (CEM). These advanced statistical methods are intended to reveal a “hidden experiment” within an observational database, and so refute or confirm a potential causal effect of assignment to an intervention and study outcome. We applied these methods to the Optum™ Research Database (ORD; Eden Prairie, MN) of electronic health records and administrative claims data to assess the effect of the 17-gene Genomic Prostate Score® (GPS™; Genomic Health, Redwood City, CA) assay on use of active surveillance (AS). In a traditional multivariable logistic regression, the GPS assay increased the use of AS by 29% (95% CI, 24%-33%). Upon applying the matching methods, the effect of the GPS assay on AS use varied between 27% and 80% and the matched data were significant among all algorithms. All matching algorithms performed well in identifying matched data that improved the imbalance in baseline covariates. By using different matching methods to assess causal inference in an observational database, we provide further confidence that the effect of the GPS assay on AS use is statistically significant and unlikely to be a result of confounding due to differences in baseline characteristics of the patients or the settings in which they were seen. [Rev Urol. 2018;20(2):69–76 doi: 10.3909/riu0799] © 2018 MedReviews, LLC®

Prostate cancer Active surveillance Evidence-based practice Comparative effectiveness research Genomic biomarker Propensity score Matching

Volume 21, Number 4 Meeting Reviews

Prostate Cancer Academy 2019 Selected Summaries

[Rev Urol. 2019;21(4):166–171] © 2020 MedReviews®, LLC

Prostate cancer Immunotherapy Active surveillance Focal therapy mpMRI PSMA-PET