摘要
Differentiation between lethal and non-lethal prostate cancer subtypes has become a very important issue in avoiding excessive treatment in an era when prostate-specific antigen （PSA） screening has reduced the rate of prostate cancer deaths by more than 20%. However, it is difficult to determine the patients who may or may not benefit from immediate treatment interventions at the time of the initial diagnosis. The selection of candidate patients who can postpone immediate treatment and undergo follow-ups with a specific surveillance program, or ＇active surveillance,＇ is a practical way to minimize overtreatment. In this review, the benefits and risks of active surveillance are discussed. Future perspectives, including imaging and new biomarkers for improving the outcomes of active surveillance programs, are also discussed.
如何区分致死性与非致死性前列腺癌亚型在预防前列腺癌过度治疗方面已经成为一个非常重要的课题，尤其在这个用前列腺特异性抗原筛查可使前列腺癌的死亡率下降大于20％的时代。然而，判断初次诊断的患者是否会受益于立即干预治疗是非常困难的。以某种监测项目来随访看起来不需要立即治疗的患者，即所谓的“积极监测”，是弥补过度治疗的一种可行的方法。本综述讨论了积极监测的利弊，对提高积极监测结果的影像和新的生物标记的未来前景也进行了展望。
