Is There a Role for Active Surveillance in Low-Risk Prostate Cancer?

Urol Int. 2015;95(2):125-31. doi: 10.1159/000371895. Epub 2015 Mar 17.

Abstract

Background: Active surveillance (AS) represents an expectant treatment strategy for clinically localized prostate cancer (PCa) with low-risk features.

Objective: The actual management as well as the pros and cons of AS were evaluated.

Methods: A systematic review of the recent literature was performed using the Medline databases.

Conclusions: Since a substantial number of men die with rather than from PCa, there is a considerable role for AS in carefully selected men. AS may also represent a strategy to reduce the burden of overtreatment rooted in intensified PSA testing. Facing the imprecision of risk stratification based on transrectal ultrasound-guided biopsy, accurate clinical staging represents a major medical challenge. Counseling and care require empathy as well as a profound understanding of the biology and the natural history of PCa.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Disease Progression
  • Early Detection of Cancer / methods*
  • Humans
  • Image-Guided Biopsy
  • Male
  • Mass Screening / methods
  • Medical Oncology / standards
  • Prostate / pathology
  • Prostate-Specific Antigen / blood
  • Prostatic Neoplasms / diagnosis*
  • Prostatic Neoplasms / diagnostic imaging
  • Prostatic Neoplasms / pathology
  • Prostatic Neoplasms / psychology
  • Risk Factors
  • Ultrasonography

Substances

  • Prostate-Specific Antigen