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Innovations in Active Surveillance Management of Early Prostate Cancer

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Epidemiology and Prevention".

Deadline for manuscript submissions: 8 August 2026 | Viewed by 895

Special Issue Editor


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Guest Editor
1. Cambridge Prostate Cancer Research and Clinical Trials Group, Cambridge, UK
2. Department of Surgery, University of Cambridge, Cambridge, UK
3. Department of Urology, Cambridge University Hospitals, Cambridge, UK
Interests: prostate cancer; risk stratification; active surveillance; prognostic markers; translational research

Special Issue Information

Dear Colleagues,

Prostate cancer is the most common cancer diagnosed in the West and the second most common male cancer globally. The majority of diagnosed men, however, will live with rather than die from prostate cancer. For many men, treatment may in fact only bring harm without any tangible survival benefit. Active surveillance is a disease management strategy that monitors early prostate cancer with a low probability of ever causing harm in a patient’s natural lifetime. In modern PSA-detected prostate cancer populations, up to a quarter of men diagnosed may be eligible for active surveillance.

Despite its importance as a management option in clinical practice, most academic literature on active surveillance is based on data extrapolated from other treatments or from expert/consensus opinion. In this Special Issue of Cancers, we seek to address this evidence gap by highlighting research that has been based on investigating cohorts of men on surveillance and in whom clinic-pathological features, prediction tools, imaging, or biomarkers have been tested and explored. We particularly welcome articles that look at the natural history of early cancers, methods for risk-adapted surveillance, and tools that may detect progression to a clinically meaningful endpoint. We look forward to receiving your submissions.

Prof. Dr. Vincent J. Gnanapragasam
Guest Editor

Manuscript Submission Information

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Keywords

  • prostate cancer
  • risk stratification
  • active surveillance
  • predictive markers
  • personalized management
  • imaging
  • biomarkers
  • clinical pathways
  • patient outcomes
  • standardizing care
  • attrition
  • cohort studies

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Published Papers (1 paper)

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Research

13 pages, 2279 KB  
Article
Application of the STRATCANS Criteria to the MUSIC Prostate Cancer Active Surveillance Cohort: A Step Towards Risk-Stratified Active Surveillance
by Ana M. Moser, Michael Wang, Ava Zamani, Sabir Meah, Stephanie Daignault-Newton, Corinne Labardee, Nicholas Dybas, Jacob Clapper, Brian R. Lane, Tudor Borza, Alice Semerjian, Vincent J. Gnanapragasam and Kevin B. Ginsburg
Cancers 2025, 17(18), 3032; https://doi.org/10.3390/cancers17183032 - 17 Sep 2025
Viewed by 765
Abstract
Background: The STRATified CANcer Surveillance (STRATCANS) model risk-stratifies patients with prostate cancer (PC) on active surveillance (AS) into three tiers based on their risk of disease progression. We applied STRATCANS to the Michigan Urological Surgery Improvement Collaborative (MUSIC) Prostate registry to assess its [...] Read more.
Background: The STRATified CANcer Surveillance (STRATCANS) model risk-stratifies patients with prostate cancer (PC) on active surveillance (AS) into three tiers based on their risk of disease progression. We applied STRATCANS to the Michigan Urological Surgery Improvement Collaborative (MUSIC) Prostate registry to assess its association with the risk of biopsy upgrading and time to definitive treatment in a diverse, real-world AS cohort. Methods: We retrospectively reviewed the MUSIC registry for PC patients on AS from 2016 to 2022 and classified patients by STRATCANS tier. Primary outcomes included biopsy upgrading to ≥Grade Group 3 (≥GG3), any biopsy upgrading, and time to definitive treatment. Results: Among 7578 men on AS, 4009, 2732, and 837 patients were in STRATCANS 1, 2, and 3, respectively. The risk of progression to ≥GG3 was 13%, 33%, and 53% for patients in STRATCANS 1, 2, and 3, respectively (p < 0.001). The rate of any biopsy upgrading was approximately 50% at 3 years across all STRATCANS tiers. STRATCANS tiers were also significantly associated with time to definitive treatment, with 16%, 28%, and 35% of men in STRATCANS 1, 2, and 3, respectively, receiving definitive treatment by 36 months. Limitations include confounding inherent to retrospective registry studies, a short 60-month follow-up period, and variability in biopsy method with no centralized pathology and radiology review. Conclusions: STRATCANS has a stepwise association with the risk of progression to ≥GG3 disease and time to definitive treatment among men on AS in the MUSIC cohort, supporting its use as a risk-based, follow-up approach in men on AS. Full article
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