The critical role of the pathologist in determining eligibility for active survlnc. as a mgmt. option in patients with prostate cancer

Consensus statement with recommendations supported by the Coll. of Amer. Pathologists, Intl. Soc. of Urological Pathol., Assoc. of Directors of Anat. and Surg. Pathol., the New Zealand Soc. of Pathologists, and the Prostate Cancer Found.

Mahul Amin, Daniel W. Lin, John L. Gore, John R. Srigley, Hema Samaratunga, Lars Egevad, Mark Rubin, John Nacey, H. Ballentine Carter, Laurence Klotz, Howard Sandler, Anthony L. Zietman, Stuart Holden, Rodolfo Montironi, Peter A. Humphrey, Andrew J. Evans, Jonathan I. Epstein, Brett Delahunt, Jesse K. McKenney, Dan Berney & 5 others Thomas M. Wheeler, Arul M. Chinnaiyan, Lawrence True, Beatrice Knudsen, M. Elizabeth H. Hammond

Research output: Contribution to journalArticle

77 Citations (Scopus)

Abstract

Context. - Prostate cancer remains a significant public health problem. Recent publications of randomized trials and the US Preventive Services Task Force recommendations have drawn attention to overtreatment of localized, low-risk prostate cancer. Active surveillance, in which patients undergo regular visits with serum prostate-specific antigen tests and repeat prostate biopsies, rather than aggressive treatment with curative intent, may address overtreatment of low-risk prostate cancer. It is apparent that a greater awareness of the critical role of pathologists in determining eligibility for active surveillance is needed. Objectives. - To review the state of current knowledge about the role of active surveillance in the management of prostate cancer and to provide a multidisciplinary report focusing on pathologic parameters important to the successful identification of patients likely to succeed with active surveillance, to determine the role of molecular tests in increasing the safety of active surveillance, and to provide future directions. Design. - Systematic review of literature on active surveillance for low-risk prostate cancer, pathologic parameters important for appropriate stratification, and issues regarding interobserver reproducibility. Expert panels were created to delineate the fundamental questions confronting the clinical and pathologic aspects of management of men on active surveillance. Results. - Expert panelists identified pathologic parameters important for management and the related diagnostic and reporting issues. Consensus recommendations were generated where appropriate. Conclusions. - Active surveillance is an important management option for men with low-risk prostate cancer. Vital to this process is the critical role pathologic parameters have in identifying appropriate candidates for active surveillance. These findings need to be reproducible and consistently reported by surgical pathologists with accurate pathology reporting.

Original languageEnglish (US)
Pages (from-to)1387-1405
Number of pages19
JournalArchives of Pathology and Laboratory Medicine
Volume138
Issue number10
DOIs
StatePublished - Oct 1 2014

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New Zealand
Prostatic Neoplasms
Advisory Committees
Prostate-Specific Antigen
Pathologists
Prostate
Public Health
Pathology
Biopsy
Safety
Serum

All Science Journal Classification (ASJC) codes

  • Pathology and Forensic Medicine
  • Medical Laboratory Technology

Cite this

The critical role of the pathologist in determining eligibility for active survlnc. as a mgmt. option in patients with prostate cancer : Consensus statement with recommendations supported by the Coll. of Amer. Pathologists, Intl. Soc. of Urological Pathol., Assoc. of Directors of Anat. and Surg. Pathol., the New Zealand Soc. of Pathologists, and the Prostate Cancer Found. / Amin, Mahul; Lin, Daniel W.; Gore, John L.; Srigley, John R.; Samaratunga, Hema; Egevad, Lars; Rubin, Mark; Nacey, John; Carter, H. Ballentine; Klotz, Laurence; Sandler, Howard; Zietman, Anthony L.; Holden, Stuart; Montironi, Rodolfo; Humphrey, Peter A.; Evans, Andrew J.; Epstein, Jonathan I.; Delahunt, Brett; McKenney, Jesse K.; Berney, Dan; Wheeler, Thomas M.; Chinnaiyan, Arul M.; True, Lawrence; Knudsen, Beatrice; Hammond, M. Elizabeth H.

In: Archives of Pathology and Laboratory Medicine, Vol. 138, No. 10, 01.10.2014, p. 1387-1405.

Research output: Contribution to journalArticle

Amin, M, Lin, DW, Gore, JL, Srigley, JR, Samaratunga, H, Egevad, L, Rubin, M, Nacey, J, Carter, HB, Klotz, L, Sandler, H, Zietman, AL, Holden, S, Montironi, R, Humphrey, PA, Evans, AJ, Epstein, JI, Delahunt, B, McKenney, JK, Berney, D, Wheeler, TM, Chinnaiyan, AM, True, L, Knudsen, B & Hammond, MEH 2014, 'The critical role of the pathologist in determining eligibility for active survlnc. as a mgmt. option in patients with prostate cancer: Consensus statement with recommendations supported by the Coll. of Amer. Pathologists, Intl. Soc. of Urological Pathol., Assoc. of Directors of Anat. and Surg. Pathol., the New Zealand Soc. of Pathologists, and the Prostate Cancer Found.', Archives of Pathology and Laboratory Medicine, vol. 138, no. 10, pp. 1387-1405. https://doi.org/10.5858/arpa.2014-0219-SA
Amin, Mahul ; Lin, Daniel W. ; Gore, John L. ; Srigley, John R. ; Samaratunga, Hema ; Egevad, Lars ; Rubin, Mark ; Nacey, John ; Carter, H. Ballentine ; Klotz, Laurence ; Sandler, Howard ; Zietman, Anthony L. ; Holden, Stuart ; Montironi, Rodolfo ; Humphrey, Peter A. ; Evans, Andrew J. ; Epstein, Jonathan I. ; Delahunt, Brett ; McKenney, Jesse K. ; Berney, Dan ; Wheeler, Thomas M. ; Chinnaiyan, Arul M. ; True, Lawrence ; Knudsen, Beatrice ; Hammond, M. Elizabeth H. / The critical role of the pathologist in determining eligibility for active survlnc. as a mgmt. option in patients with prostate cancer : Consensus statement with recommendations supported by the Coll. of Amer. Pathologists, Intl. Soc. of Urological Pathol., Assoc. of Directors of Anat. and Surg. Pathol., the New Zealand Soc. of Pathologists, and the Prostate Cancer Found. In: Archives of Pathology and Laboratory Medicine. 2014 ; Vol. 138, No. 10. pp. 1387-1405.
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abstract = "Context. - Prostate cancer remains a significant public health problem. Recent publications of randomized trials and the US Preventive Services Task Force recommendations have drawn attention to overtreatment of localized, low-risk prostate cancer. Active surveillance, in which patients undergo regular visits with serum prostate-specific antigen tests and repeat prostate biopsies, rather than aggressive treatment with curative intent, may address overtreatment of low-risk prostate cancer. It is apparent that a greater awareness of the critical role of pathologists in determining eligibility for active surveillance is needed. Objectives. - To review the state of current knowledge about the role of active surveillance in the management of prostate cancer and to provide a multidisciplinary report focusing on pathologic parameters important to the successful identification of patients likely to succeed with active surveillance, to determine the role of molecular tests in increasing the safety of active surveillance, and to provide future directions. Design. - Systematic review of literature on active surveillance for low-risk prostate cancer, pathologic parameters important for appropriate stratification, and issues regarding interobserver reproducibility. Expert panels were created to delineate the fundamental questions confronting the clinical and pathologic aspects of management of men on active surveillance. Results. - Expert panelists identified pathologic parameters important for management and the related diagnostic and reporting issues. Consensus recommendations were generated where appropriate. Conclusions. - Active surveillance is an important management option for men with low-risk prostate cancer. Vital to this process is the critical role pathologic parameters have in identifying appropriate candidates for active surveillance. These findings need to be reproducible and consistently reported by surgical pathologists with accurate pathology reporting.",
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T2 - Consensus statement with recommendations supported by the Coll. of Amer. Pathologists, Intl. Soc. of Urological Pathol., Assoc. of Directors of Anat. and Surg. Pathol., the New Zealand Soc. of Pathologists, and the Prostate Cancer Found.

AU - Amin, Mahul

AU - Lin, Daniel W.

AU - Gore, John L.

AU - Srigley, John R.

AU - Samaratunga, Hema

AU - Egevad, Lars

AU - Rubin, Mark

AU - Nacey, John

AU - Carter, H. Ballentine

AU - Klotz, Laurence

AU - Sandler, Howard

AU - Zietman, Anthony L.

AU - Holden, Stuart

AU - Montironi, Rodolfo

AU - Humphrey, Peter A.

AU - Evans, Andrew J.

AU - Epstein, Jonathan I.

AU - Delahunt, Brett

AU - McKenney, Jesse K.

AU - Berney, Dan

AU - Wheeler, Thomas M.

AU - Chinnaiyan, Arul M.

AU - True, Lawrence

AU - Knudsen, Beatrice

AU - Hammond, M. Elizabeth H.

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