Active Surveillance for Prostate Cancer: A Systematic Review of the Literature

Abstract

Please visit www.eu-acme.org/ europeanurology to read and answer questions on-line. The EU-ACME credits will then be attributed automatically. AbstractContext: Prostate cancer (PCa) remains an increasingly common malignancy worldwide. The optimal management of clinically localized, early-stage disease remains unknown, and profound quality of life issues surround PCa interventions. Objective: To systematically summarize the current literature on the management of low-risk PCa with active surveillance (AS), with a focus on patient selection, outcomes, and future research needs.

Novel Tools to Improve Patient Selection and Monitoring on Active Surveillance for Low-risk Prostate Cancer: A Systematic Review

“…Even with the most stringent selection criteria, some patients with apparently low-risk disease actually harbour unfavourable disease due to inaccuracies in currently used (repeat) biopsy protocols [4,5]. In contrast, current AS criteria may be too strict, thereby excluding some patients in whom expectant management would be appropriate and safe [6].…”

Pathological outcome for Chinese patients with low-risk prostate cancer eligible for active surveillance and undergoing radical prostatectomy: comparison of six different active surveillance protocols

“…The ultimate objective is to delay or avoid the morbidities associated with radical treatments without compromising survival. [8][9][10] Although AS is an established management option for low-risk prostate cancer, different AS protocols have been adopted. [11][12][13][14][15][16][17] The most commonly used include those from the University of Toronto, 11 Royal Marsden, 12 John Hopkins, 13,14 University of California San Francisco (UCSF), 15 Memorial Sloan Kettering Cancer Center (MSKCC), 16 and Prostate Cancer Research International: Active Surveillance (PRIAS).…”

‘Should I get a PSA test?’ – the question is not that simple

“…9 Disease progression is one driving factor for abandoning AS, but anxiety is clearly another factor for why some men elect for treatment. However, there is every reason to believe that this mindset can change.…”