Active surveillance for low-risk prostate cancer

• Published in: Critical reviews in oncology/hematology Vol. 85; no. 3; pp. 295 - 302
• Main Authors: Bangma, Chris H, Bul, Meelan, van der Kwast, Theo H, Pickles, Tom, Korfage, Ida J, Hoeks, Caroline M, Steyerberg, Ewout W, Jenster, Guido, Kattan, Michael W, Bellardita, Lara, Carroll, Peter R, Denis, Louis J, Parker, Chris, Roobol, Monique J, Emberton, Mark, Klotz, Laurence H, Rannikko, Antti, Kakehi, Yoshiyuki, Lane, Janet A, Schröder, Fritz H, Semjonow, Axel, Trock, Bruce J, Valdagni, Riccardo
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ireland Ltd 01-03-2013
• Subjects: Active surveillance; Biomarkers; Biomarkers, Tumor; Diagnostic Imaging; Disease Management; Early Detection of Cancer; Europe; Health Personnel; Hematology, Oncology and Palliative Medicine; Humans; Imaging; Male; Nomograms; Overdiagnosis; Population Surveillance; Prognosis; Prostate cancer; Prostatic Neoplasms - diagnosis; Prostatic Neoplasms - epidemiology; Risk; Screening; SEER Program; Europe; ASIST; Study of Active Montoring Sweden; Active Surveillance Magnetic Resonance Imaging Study; ERSPC; PCa; Men's Eating and Living study; European Randomized Study of Screening for Prostate Cancer; Prostate Cancer Research International: Active Surveillance; SAMS; radical prostatectomy; PSA doubling time; Imaging; Nomograms; quality adjusted life years; PSA; PSADT; digital rectal examination; Biological Investigations in Active Surveillance study; Overdiagnosis; BIAS; MEAL; QOL; Prostate Active Surveillance Study; Screening; AS; prostate cancer; PRIAS; PASS; DRE; QALY; Biomarkers; quality of life; active surveillance; RP; prostate-specific antigen; Active surveillance; Prostate cancer
• ISSN: 1040-8428; 1879-0461
• DOI: 10.1016/j.critrevonc.2012.07.005

Abstract Active surveillance (AS) is an important management strategy for men diagnosed with low-risk prostate cancer (PCa). The need for AS is increasing due to the awareness that many PCa are identified that show a low growth potential and therefore are likely to remain clinically asymptomatic during the lifetime of an individual. Currently there is no good method to prevent the overdiagnosis of indolent cancers upfront. During the last decade, several studies on AS around the world have made observations that feed the discussion on how to select and monitor these patients, how to proceed with the research to develop a better and more precise clinical definition of indolent cancers and how to manage men under AS clinically. Furthermore, patients’ perspectives have become clearer, and quality of life studies give direction to the practical approach and care for patients and partners. This paper reflects the consensus on the state of the art and the future direction of AS, based on the Inside Track Conference “Active Surveillance for low risk prostate cancer” (Chairmen: C.H. Bangma, NL, and L. Klotz, CA; Co-Chairmen: L.J. Denis, BE, and C. Parker, UK; Scientific Coordinators: M. J. Roobol, NL, and E.W. Steyerberg, NL), organized by the European School of Oncology in collaboration with Europa Uomo in Rotterdam, the Netherlands in January 2012. Topics for discussion were the optimisation of patient selection based on indolent disease definition, the incorporation of therapeutic agents into AS programs, the optimisation of patient care, and the application of emerging technologies and biomarkers.