Careful Selection and Close Monitoring of Low-Risk Prostate Cancer Patients on Active Surveillance Minimizes the Need for Treatment

Soloway, Mark S.; Soloway, Cynthia T.; Eldefrawy, Ahmed; Acosta, Kristell; Kava, Bruce R.; Manoharan, M.

doi:10.1016/j.eururo.2010.08.027

Cited by 244 publications

(201 citation statements)

References 25 publications

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“…An RCT comparing RP with observation detected no significant difference between groups for prostate-cancer mortality rate and all-cause mortality rate after 12 years, 20 and the two most commonly reported adverse events associated with active surveillance (urinary incontinence and erectile dysfunction) [19][20][21][22] are similarly reported in other studies of immediate active treatments. [23][24] Therefore AS does not present any new or different harm.…”

Section: Recommendationmentioning

confidence: 99%

“…[5][6][7][8][9][12][13][14][15][16][18][19][20][21][22]29,32,33 The studies reporting their active surveillance protocol conducted multicore (6-to 17-core) biopsies every 1 to 2 years. 5,10,12,[15][16][17][18]21,23,[28][29][30][33][34][35] Five studies conducted multicore biopsies every 2 to 4 years. 8,11,13,19,32 Regarding Multiparametric MRI, it has been shown to be a good predictor of disease reclassification.…”

Section: Recommendationmentioning

confidence: 99%

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Active surveillance for the management of localized prostate cancer: Guideline recommendations

Morash

Tey

Agbassi

et al. 2015

CUAJ

190

129

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Introduction: The objective is to provide guidance on the role of active surveillance (AS) as a management strategy for low-risk prostate cancer patients and to ensure that AS is offered to appropriate patients assessed by a standardized protocol. Prostate cancer is often a slowly progressive or sometimes non-progressive indolent disease diagnosed at an early stage with localized tumours that are unlikely to cause morbidity or death. Standard active treatments for prostate cancer include radiotherapy (RT) or radical prostatectomy (RP), but the harms from over diagnosis and overtreatment are of a significant concern. AS is increasingly being considered as a management strategy to avoid or delay the potential harms caused by unnecessary radical treatment. Methods: A literature search of MEDLINE, EMBASE, the Cochrane library, guideline databases and relevant meeting proceedings was performed and a systematic review of identified evidence was synthesized to make recommendations relating to the role of AS in the management of localized prostate cancer. Results: No exiting guidelines or reviews were suitable for use in the synthesis of evidence for the recommendations, but 59 reports of primary studies were identified. Due to studies being either non-comparative or heterogeneous, pooled meta-analyses were not conducted. Conclusion:The working group concluded that for patients with low-risk (Gleason score ≤6) localized prostate cancer, AS is the preferred disease management strategy. Active treatment (RP or RT) is appropriate for patients with intermediate-risk (Gleason score 7) localized prostate cancer. For select patients with low-volume Gleason 3+4=7 localized prostate cancer, AS can be considered.

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Section: Recommendationmentioning

confidence: 99%

Section: Recommendationmentioning

confidence: 99%

Active surveillance for the management of localized prostate cancer: Guideline recommendations

Morash

Tey

Agbassi

et al. 2015

CUAJ

190

129

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“…Criteria for AS set forth from published series are shown in Table 1 [7][8][9][10][11][12][13][14][15]. First described in 1994, and then updated in 2004, the Epstein criteria integrate biopsy criteria with clinical data to identify potentially low-risk tumors and are among the most commonly used methods to identify lowrisk disease [16,17].…”

Section: Criteria For Active Surveillancementioning

confidence: 99%

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

et al. 2012

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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.

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“…The distinction is particularly important in that neither oncologic, nor quality of life, outcomes from patients assigned to observation in older randomized trials, [8,14], nor those identified in population-based registries as receiving conservative management, can be considered representative of those expected with contemporary active surveillance. Table 1 summarizes the published prospective experience with active surveillance, comprising more than 2900 patients [15][16][17][18][19][20][21][22][23]. These studies differ in terms of their eligibility and triggers for intervention.…”

Section: Active Surveillance Resultsmentioning

confidence: 99%

Active Surveillance for Low-Risk Prostate Cancer

Klotz

2015

Curr Urol Rep

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Careful Selection and Close Monitoring of Low-Risk Prostate Cancer Patients on Active Surveillance Minimizes the Need for Treatment

Cited by 244 publications

References 25 publications

Active surveillance for the management of localized prostate cancer: Guideline recommendations

Active surveillance for the management of localized prostate cancer: Guideline recommendations

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

Active Surveillance for Low-Risk Prostate Cancer

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