ReviewProstate international2026
Patients with high-risk features on active surveillance for prostate cancer.
Review in Prostate international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background/objectives: With the increasing incidence of prostate cancer worldwide, active surveillance (AS) remains a cornerstone in the management of men with low-risk disease. While the criteria for AS in low-risk prostate cancer are well established, its appropriateness for men with higher-risk features is less clearly defined. This review aims to evaluate the evidence supporting AS in men with a family history of prostate cancer, Prostate Imaging Reporting and Data System (PI-RADS) 4 or 5 lesions, and favorable intermediate-risk International Society of Urological Pathology (ISUP) Grade Group (GG) 2 disease. Methods: A comprehensive literature review was conducted using PubMed, Embase, and The Cochrane Library. Eligible studies included those assessing outcomes of AS in men with higher-risk features, including family history of prostate or associated malignancies, PI-RADS 4-5 lesions on magnetic resonance imaging, or favorable risk ISUP GG2 disease. Studies were excluded if participants had a life expectancy of less than 10 years or had previously received definitive treatment for prostate cancer. Results: Recent evidence suggests that a family history of prostate cancer may confer an increased risk of disease progression on AS; however, current data do not justify exclusion from surveillance on this basis alone. Two single-center studies demonstrated that men with PI-RADS 5 lesions at AS enrolment exhibited a higher rate of disease upgrading, with 70% progressing to ISUP GG2 and 25-33% to GG3 or higher at confirmatory biopsy. Increasing evidence supports the inclusion of selected men with favorable GG2 disease in AS protocols, provided the absence of high-risk clinical, biochemical, or radiological features. Approximately 50% may require definitive treatment within five years. Conclusions: AS remains a viable management option for appropriately selected men with higher-risk features, accompanied by rigorous monitoring and informed patient counselling. The emerging role of prostate-specific membrane antigen positron emission tomography imaging in risk stratification for intermediate-risk disease warrants further investigation through prospective studies.
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