Defining the ideal patient for active surveillance in localized prostate cancer and the impact of active surveillance studies on clinical practice

  • Ayhan Dirim
  • Hakan Özkardeş

Bull Urooncol 2011;10(2):41-46

Active surveillance can be defined as postponing curative treatment without missing cure chance in low-risk prostate cancer cases. Success of active surveillance mainly depends on appropriate patient selection. However, neither a consensus nor a protocole exists for ideal patient selection, methods of follow-up or criteria of switching into definitive treatment before losing chance of cure. Active surveillance studies unfortunately bear the disadvantages of being retrospective, limited number of cases and variability of inclusion criteria. In addition, relative shortness of mean follow-up times hinder prediction of long-term risks and outcome of active surveillance. Cancer specific survival rates in several active surveillance series have been reported to be nearly 100%. However, one in every three cases has been switched into definitive treatment during follow-up.

Keywords: Active surveillance; localized prostate cancer; clinically insignificant prostate cancer; treatment