A New Technique for Treating Low-risk Prostate Cancer—Super Active Surveillance

The treatment methods for patients with localized low-risk prostate cancer whose life expectancy is > 10 years mainly include radical prostatectomy, radiotherapy, active surveillance (AS), and focal therapy of low-risk prostate cancer. Research shows that only 3% of patients with low-risk prostate cancer experience disease progression or death, which indicates that there is overtreatment. The number of patients who choose active monitoring is increasing, but in the process of treatment, they often suffer great psychological pressure. Therefore, we are trying to adopt a more active treatment mode than active surveillance-Super Active Surveillance (Super-AS). Super-AS involves the application of ¹⁸F-PSMA PET/MR multimodal medical imaging, combined with real-time fusion of intraoperative transrectal ultrasound images, thereby enabling precise navigation for targeted argon-helium cryoablation therapy. The significance of Super-AS lies in its ability to effectively manage tumors in oncology while exerting minimal impact on functionality. Even if the focal therapy fails, the subsequent radical prostatectomy makes no significant difference in the overall oncological control, functional (urinary orifice and sexual function), and postoperative complications. Therefore, precise focal therapy can be an alternative transitional treatment for patients, from active monitoring to radical treatment, and it can also be seen as a "future bridge" for the treatment of localized prostate cancer. Consequently, Super-AS is a potentially promising therapeutic option for patients who meet the indications.