Treatment of Low-Risk Localised Prostate Cancer (ISUP Grade Group 1, PSA <10 ng/mL)
Men with localised prostate cancer classified as low-risk — ISUP grade group 1, PSA below 10 ng/mL, and clinical stage cT1-2a — and a life expectancy exceeding 10 years represent a distinct clinical population for whom careful long-term management is a clinical priority.
Low-risk localised prostate cancer (ISUP grade group 1, PSA <10 ng/mL, cT1-2a) in a male patient with life expectancy greater than 10 years — a setting where active disease monitoring is the recommended standard of care, and curative treatment remains an option if disease progresses.
The evidence-based strategy for this population centres on structured active surveillance, incorporating scheduled PSA monitoring, imaging, and repeat tissue assessment at defined intervals. The full protocol specifies the precise components and decision criteria.
Clinical targets include maintaining stable PSA, no upgrading of the ISUP grade group on repeat biopsy, and no disease progression detected on MRI follow-up.
References
Active surveillance should be considered standard of care for all patients with a life expectancy > 10 years (based on comorbidities and age) and where curative treatment would be considered in the case of disease progression.
Manage patients with a life expectancy > 10 years and low-risk disease with active surveillance.
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