Active surveillance for early-stage prostate cancer - Review of the current literature

TY - JOUR

T1 - Active surveillance for early-stage prostate cancer - Review of the current literature

AU - Dall'Era, M A

AU - Cooperberg, M R

AU - Chan, J M

AU - Davies, B J

AU - Albertsen, P C

AU - Klotz, L H

AU - Warlick, C A

AU - Holmberg, L

AU - Bailey, D E

AU - Wallace, M E

AU - Kantoff, P W

AU - Carroll, P R

PY - 2008/4/15

Y1 - 2008/4/15

N2 - The natural history of prostate cancer is remarkably heterogeneous and, at this time, not completely understood. The widespread adoption and application of prostate-specific antigen (PSA) screening has led to a dramatic shift toward the diagnosis of low-volume, nonpalpable, early-stage rumors. Autopsy and early observational studies have shown that approximately I in 3 men aged >50 years has histologic evidence of prostate cancer, with a significant portion of tumors being small and possibly clinically insignificant. Utilizing the power of improved contemporary risk stratification schema to better identify patients with a low risk of cancer progression, several centers are gaining considerable experience with active surveillance and delayed, selective, and curative therapy. A literature review was performed to evaluate the rationale behind active surveillance for prostate cancer and to describe the early experiences from surveillance protocols. It appears that a limited number of men on active surveillance have required treatment, with the majority of such men having good outcomes after delayed selective intervention for progressive disease. The best candidates for active surveillance are being defined, as are predictors of active treatment. The psychosocial ramifications of surveillance for prostate cancer can be profound and future needs and unmet goals will be discussed

AB - The natural history of prostate cancer is remarkably heterogeneous and, at this time, not completely understood. The widespread adoption and application of prostate-specific antigen (PSA) screening has led to a dramatic shift toward the diagnosis of low-volume, nonpalpable, early-stage rumors. Autopsy and early observational studies have shown that approximately I in 3 men aged >50 years has histologic evidence of prostate cancer, with a significant portion of tumors being small and possibly clinically insignificant. Utilizing the power of improved contemporary risk stratification schema to better identify patients with a low risk of cancer progression, several centers are gaining considerable experience with active surveillance and delayed, selective, and curative therapy. A literature review was performed to evaluate the rationale behind active surveillance for prostate cancer and to describe the early experiences from surveillance protocols. It appears that a limited number of men on active surveillance have required treatment, with the majority of such men having good outcomes after delayed selective intervention for progressive disease. The best candidates for active surveillance are being defined, as are predictors of active treatment. The psychosocial ramifications of surveillance for prostate cancer can be profound and future needs and unmet goals will be discussed

U2 - 10.1002/cncr23373

DO - 10.1002/cncr23373

M3 - Literature review

VL - 112

SP - 1650

EP - 1659

JO - Cancer

JF - Cancer

IS - 8

ER -