Bibliographic record
Abstract
PURPOSE OF REVIEW: To summarize the current understanding of the natural history and molecular biology of low-risk prostate cancer, and review the indications for surveillance and focal therapy. RECENT FINDINGS: Low-risk prostate cancer, diagnosed in 40-50% of newly diagnosed men in a screened population, represents overdiagnosis in most cases. Gleason pattern 3 cells typically lack the molecular machinery and the genetic abnormalities, which characterize true cancers, with two important caveats. Thirty percent of patients diagnosed with low-risk prostate based on a systematic biopsy cancer harbor higher-grade cancer that is unrepresented on the biopsy. Secondly, a very small minority harbor prehistologic molecular alterations that result in progression to more aggressive disease. Favorable-risk prostate cancer is better viewed as one of multiple risk factors for the presence of higher-grade prostate cancer, and should be managed with close follow-up. Radical intervention should be reserved for clear evidence of more aggressive disease. Focal therapy should be offered to men with higher-risk disease either at baseline, as an alternative to whole gland radiation or surgery or when active surveillance 'fails' (the patient transitions from low risk to higher risk). The two strategies should be seen as complimentary elements of care that can be applied in a risk-stratified manner - taking account of patient preference - from the outset or in sequence SUMMARY: Active surveillance is appropriate for most men with low-risk prostate cancer, and focal therapy may complement active surveillance for those men wishing to continue a tissue-preserving strategy.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".