Is Active Surveillance an option for the management of men with low-grade prostate cancer and a positive family history?

Low-grade prostate cancer can be managed through active surveillance (AS), an approach that monitors the disease rather than treating it immediately. However, for men with a family history of prostate cancer, the risk of disease progression is higher.

This study examined 656 patients in AS, finding that those with a family history had a higher risk of reclassification than those without. Despite this, some factors may indicate a lower risk of progression: a negative MRI, a low disease volume, and a Prostate Specific Antigen Density (PSAD) value of less than 0.15 ng/ml.

In conclusion, while family history increases the risk of reclassification in low-grade prostate cancer, the presence of favorable factors can still make active surveillance a manageable option for patients.

Riccardo Leni a,b, Giorgio Gandaglia a,b, Armando Stabile a,b, Elio Mazzone a,b,
Francesco Pellegrino a,b, Simone Scuderi a,b, Daniele Robesti a,b, Francesco Barletta a,b,
Giuseppe Ottone Cirulli a,b, Vito Cucchiara a,b, Emanuele Zaffuto c,d, Federico Deho` c,d,
Francesco Montorsi a,b, Alberto Briganti a,b

a Division of Oncology/Unit of Urology, Soldera Prostate Cancer Lab, URI, IRCCS Ospedale San Raffaele, Milan, Italy;
b Vita-Salute San Raffaele University, Milan, Italy,
Italy;
c Department of Urology, Circolo and Fondazione Macchi Hospital-ASST Sette Laghi, Varese, Italy;
d University of Insubria, Varese, Italy