Introduction: Active surveillance has emerged as a valid therapeutic option in patients with low-risk prostate cancer, allowing for the deferral of definitive treatment until the time of possible disease progression. Although it is known that physical activity plays a protective role in the onset and progression of this tumor, its impact on patients with low-risk disease who are managed with active surveillance remains unclear. Our scoping review aims to summarize the existing evidence on this subject. Evidence Acquisition: On 9 April 2023, a systematic search was conducted using the PubMed and Scopus databases. The search employed the combination of the following terms: (“prostate cancer” OR “prostate tumor”) AND (“active surveillance”) AND (“physical activity” OR “physical exercise” OR “physical intensive activity” OR “intensive exercise”) AND (“lifestyle”). Out of the 506 identified articles, 9 were used for the present scoping review, and their results were reported according to the PRISMA-ScR statement. Evidence Synthesis: We discovered a lack of uniformity in the assessment of PA and its stratification by intensity. There was no consensus regarding what constitutes cancer progression in patients choosing expectant management. In terms of the impact of PA on AS outcomes, conflicting results were reported: some authors found no correlation, while others (six of total studies included) revealed that active men experience smaller increases in PSA levels compared to their sedentary counterparts. Additionally, higher levels of exercise were associated with a significantly reduced risk of PCa reclassification. Conclusion: Due to the heterogeneity of the methodologies used in the available studies and the conflicting results reported, it is not possible to draw definitive conclusions concerning the role physical activity may play in the risk of prostate cancer progression in men managed with active surveillance.
引言：对于低风险前列腺癌患者，主动监测已成为一种有效的治疗选择，可将确定性治疗推迟至可能发生疾病进展时。尽管已知体力活动对该肿瘤的发生和进展具有保护作用，但其对接受主动监测的低风险患者的影响尚不明确。本范围综述旨在总结该主题的现有证据。 证据获取：2023年4月9日，通过PubMed和Scopus数据库进行系统检索。检索采用以下术语组合：（“前列腺癌”或“前列腺肿瘤”）与（“主动监测”）与（“体力活动”或“体育锻炼”或“高强度体力活动”或“高强度运动”）与（“生活方式”）。在506篇已识别文章中，9篇被纳入本范围综述，其结果根据PRISMA-ScR声明进行报告。 证据综合：我们发现现有研究对体力活动的评估及其强度分层缺乏统一标准。对于选择期待治疗的患者中癌症进展的定义亦无共识。关于体力活动对主动监测结果的影响，现有报告存在矛盾：部分作者未发现相关性，而其他研究者（占纳入研究总数的六项）显示，与久坐人群相比，积极活动的患者PSA水平增幅更小。此外，更高水平的运动与前列腺癌风险再分类的显著降低相关。 结论：由于现有研究方法存在异质性且报告结果相互矛盾，目前无法就体力活动对接受主动监测的前列腺癌患者疾病进展风险的影响得出明确结论。
肿瘤(癌症)患者之家