Long-term outcomes of active surveillance (AS) for selected patient cohorts, as well
as controlled trials randomizing men with localized prostate cancer (CaP) for treatment
confirm the very favorable disease-specific outcomes when low-risk CaP is initially
managed expectantly.
1
,
2
,
3
Risk stratification has since then improved due to application of nomograms, MRI,
and extended (targeted) biopsy protocols, further reducing the likelihood of undergrading
significant disease. The eligibility for AS is based on different tumor (eg, stage,
PSA, density, MRI, Gleason score, and other biopsy details) and patient (eg, family
history, LUTS, anxiety and stress levels) characteristics.
4
However, the attitude of involved healthcare professionals towards expectant management
has a major, often decisive, impact in the shared-decision making process. Reasons
for not recommending AS may include lack of confidence in the favorable outcome, but
also financial or logistic considerations.To read this article in full you will need to make a payment
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References
- Long-term follow-up of a large active surveillance cohort of patients with prostate cancer.J Clin Oncol. 2015; 33: 272-277
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Briganti, MacLenan, Marconi, et al. European Association of Urology (EAU) guidelines: do we care? Reflections from the EAU impact assessment of guidelines implementation and education group. BJU Int. 117:850–851.
- A Decade of Active Surveillance in the PRIAS study: an update and evaluation of the criteria used to recommend a switch to active treatment.Eur Urol. 2016; 70: 954-960
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