January 18, 2026

E16 - Prostate Cancer Surveillance

11 minutes

E16 | 12 min | Latest | Publication Link

Podcast based on: Sandhu, K.; Lophatananon, A.; Gnanapragasam, V.J. The Impact of Endpoint Definitions on Predictors of Progression in Active Surveillance for Early Prostate Cancer. Cancers 2026, 18, 292. https://doi.org/10.3390/cancers18020292

Type: Article | Publication date: 17 January 2026

Summary: Active surveillance (AS) is a critically important management strategy for men with favourable-prognosis prostate cancer. However, there is no standardised or internationally agreed-upon definition of a disease progression endpoint for when AS should stop. This has led to uncertainty regarding which baseline variables reliably predict progression. In the literature, there has also been a multitude of proposed biopsy and imaging metrics that are purported to predict AS progression. We utilised the STRATified CANcer Surveillance (STRATCANs) prospective AS database to assess the utility of different clinicopathological variables in predicting progression and against different contemporary AS endpoint definitions. In this study, we found that the AS endpoint definition appears to determine which variables predict progression. Neither the addition of biopsy nor imaging metrics added consistent incremental value in better predicting progression events. PSA density, in contrast, consistently predicted progression events across different endpoint definitions.

Keywords: prostate cancer; active surveillance; STRATCANs; Cambridge prognostic group

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