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

Marc Dall'Era, Matthew R. Cooperberg, June M. Chan, Benjamin J. Davies, Peter C. Albertsen, Laurence H. Klotz, Christopher A. Warlick, Lars Holmberg, Donald E. Bailey, Meredith E. Wallace, Philip W. Kantoff, Peter R. Carroll

Research output: Contribution to journalArticle

236 Scopus citations

Abstract

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 tumors. Autopsy and early observational studies have shown that approximately 1 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.

Original languageEnglish (US)
Pages (from-to)1650-1659
Number of pages10
JournalCancer
Volume112
Issue number8
DOIs
StatePublished - Apr 15 2008

Keywords

  • Active surveillance
  • Prostate cancer
  • Review
  • Risk stratification

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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    Dall'Era, M., Cooperberg, M. R., Chan, J. M., Davies, B. J., Albertsen, P. C., Klotz, L. H., Warlick, C. A., Holmberg, L., Bailey, D. E., Wallace, M. E., Kantoff, P. W., & Carroll, P. R. (2008). Active surveillance for early-stage prostate cancer: Review of the current literature. Cancer, 112(8), 1650-1659. https://doi.org/10.1002/cncr.23373