The contemporary experiences of AS for men with intermediate-risk features suggest that although these men are at higher risk for eventual prostate-directed treatment, some are not significantly compromising chances for longer-term cure. Men with more than minimal Gleason pattern 4, however, must be carefully selected and surveyed for early signs of progression and may be at increased risk of metastases. Incorporating information from advanced imaging and biomarker technology will likely individualize future treatment decisions while improving overall surveillance strategies.
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Dall’Era et al. (2016) studied this question.
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