Prostate cancer is the leading male cancer worldwide. There remains a controversy as to which patients have indolent disease and which patients present an aggressive disease needing treatment with intent to cure. Because of quality of life impairment associated with treatment by radiation or surgery, active surveillance (AS) is a valid management option to avoid or differ aggressive treatment. Traditionally, AS was reserved for men with low risk prostate cancer, however intermediate risk patients are more and more found in AS cohorts. The aim of this review is to describe the place of AS in intermediate risk patients and the perspectives offered by such a treatment modality.
Siegel, R., Naishadham, D. and Jemal, A. (2013) Cancer Statistics. CA: A Cancer Journal for Clinicians, 63, 11-30. https://doi.org/10.3322/caac.21166
Ries, L.A.G., Melbert, D., Krapcho, M., et al. (2008) SEER Cancer Statistics Review, 1975-2005. National Cancer Institute, Bethesda, MD.
Lu-Yao, G.L., Albertsen, P.C., Moore, D.F., et al. (2009) Outcomes of Localized Prostate Cancer Following Conservative Management. JAMA, 302, 1202-1209. https://doi.org/10.1001/jama.2009.1348
Cooperberg, M.R., Broering, J.M., Kantoff, P.W. and Carroll, P.R. (2007) Contemporary Trends in Low Risk Prostate Cancer: Risk Assessment and Treatment. Journal of Urology, 178, S14-S19. https://doi.org/10.1016/j.juro.2007.03.135
Loeb, S., Berglund, A. and Stattin, P. (2013) Population-Based Study of Utilization and Determinants of Active Surveillance and Watchful Waiting for Low- and Intermediate-Risk Prostate Cancer. Journal of Urology, 190, 1742-1749. https://doi.org/10.1016/j.juro.2013.05.054
D’Amico, A.V. (2002) Combined-Modality Staging in Predicting Prostate-Specific Antigen Outcome after Definitive Local Therapy for Men with Clinically Localized Prostate Cancer. In: Prostate Cancer: Principles & Practice, Lippincott Williams & Wilkins, Philadelphia, PA, 254-268.
Cooperberg, M.R., Pasta, D.J., Elkin, E.P., Litwin, M.S., Latini, D.M., Du Chane, J. and Carroll, P.R. (2005) The University of California, San Francisco Cancer of the Prostate Risk Assessment Score: A Straightforward and Reliable Preoperative Predictor of Disease Recurrence after Radical Prostatectomy. Journal of Urology, 173, 1938-1942. https://doi.org/10.1097/01.ju.0000158155.33890.e7
Kattan, M.W., Eastham, J.A., Stapleton, A.M., Wheeler, T.M. and Scardino, P.T. (1998) A Preoperative Nomogram for Disease Recurrence Following Radical Prostatectomy for Prostate Cancer. Journal of the National Cancer Institute, 90, 766-771. https://doi.org/10.1093/jnci/90.10.766
Nakanishi, H., Wang, X., Ochiai, A., et al. (2007) A Nomogram for Predicting Low-Volume/Low-Grade Prostate Cancer: A Tool in Selecting Patients for Active Surveillance. Cancer, 110, 2441-2447. https://doi.org/10.1002/cncr.23055
Bangma, C.H., Roobol, M.J. and Steyerberg, E.W. (2009) Predictive Models in Diagnosing Indolent Cancer. Cancer, 115, 3100-3106. https://doi.org/10.1002/cncr.24347
Iremashvili, V., Burdick-Will, J. and Soloway, M.S. (2013) Improving Risk Stratification in Patients with Prostate Cancer Managed by Active Surveillance: A Nomogram Predicting the Risk of Biopsy Progression. BJU International, 112, 39-44. https://doi.org/10.1111/bju.12112
Conti, S.L., Dall’ ERA, M., Fradet, V., Cowan, J.E., Simko, J. and Carroll, P.R. (2009) Pathological Outcomes of Candidates for Actives Surveillance of Prostate Cancer. Journal of Urology, 181, 1628-1633. https://doi.org/10.1016/j.juro.2008.11.107
Latini, D.M., Hart, S.L., Knight, S.J., Cowan, J.E., Ross, P.L., Duchane, J. and Carroll, P.R. (2007) CaPSURE Investigators: The Relationship between Anxiety and Time to Treatment for Patients with Prostate Cancer on Surveillance. Journal of Urology, 178, 826-831. https://doi.org/10.1016/j.juro.2007.05.039
Cooperberg, M.R., Broering, J.M. and Caroll, P.R. (2010) Time Trends and Local Variation in Primary Treatment of Localized Prostate Cancer. Journal of Clinical Oncology, 28, 1117-1123. https://doi.org/10.1200/JCO.2009.26.0133
Pardo, Y., Guedea, F., Aguilo, F., et al. (2010) Quality-of-Life Impact of Primary Treatments for Localized Prostate Cancer in Patients without Hormonal Treatment. Journal of Clinical Oncology, 28, 4687-4696. https://doi.org/10.1200/JCO.2009.25.3245
Sanda, M.G., Dunn, R.L., Michalski, J., et al. (2008) Quality of Life and Satisfaction with Outcome among Prostate-Cancer Survivors. The New England Journal of Medicine, 358, 1250-1261. https://doi.org/10.1056/NEJMoa074311
Draisma, G., Etzioni, R., Tsodikov, A., Mariotto, A., Wever, E., Gulati, R., Feuer, E. and de Koning, H. (2009) Lead Time and over Diagnostic in Prostate Specific Antigen Screening: Importance of Methods and Context. Journal of the National Cancer Institute, 101, 374-383. https://doi.org/10.1093/jnci/djp001
Moyer, V.A., et al. (2012) Screening for Prostate Cancer: U.S. Preventive Services Task Force Recommendation Statement. Annals of Internal Medicine, 157, 120-134. https://doi.org/10.7326/0003-4819-157-2-201207170-00459
Scosyrev, E., Wu, G., Mohile, S. and Messing, F.M. (2012) Prostate Specific Antigen Screening for Prostate Cancer and Risk of Overt Metastatic Disease at Presentation: Analysis of Trends over Time. Cancer, 118, 5768-5776. https://doi.org/10.1002/cncr.27503
Ganz, P.A., Barry, J.M., Burke, W., et al. (2012) National Institutes of Health State-of-the-Science Conference: Role of Active Surveillance in the Management of Men with Localized Prostate Cancer. Annals of Internal Medicine, 156, 591-595. https://doi.org/10.7326/0003-4819-156-8-201204170-00010
Dall’Era, M.A., Cooperberg, M.R., Chan, J.M., et al. (2008) Active Surveillance for Early-Stage Prostate Cancer: Review of the Current Literature. Cancer, 112, 1650-1659. https://doi.org/10.1002/cncr.23373
Warlick, C., Trock, B.J., Landis, P., et al. (2006) Delayed versus Immediate Surgical Intervention and Prostate Cancer Outcome. Journal of the National Cancer Institute, 98, 355-357. https://doi.org/10.1093/jnci/djj072
Cooperberg, M.R., Cowan, J.E., Hilton, J.F., et al. (2011) Outcomes of Active Surveillance for Men with Intermediate-Risk Prostate Cancer. Journal of Clinical Oncology, 29, 228-234. https://doi.org/10.1200/JCO.2010.31.4252
Van As, N.J., Norman, A.R., Thomas, K., et al. (2008) Predicting the Probability of Deferred Radical Treatment for Localized Prostate Cancer Managed by Active Surveillance. European Urology, 54, 1297-1305. https://doi.org/10.1016/j.eururo.2008.02.039
Catalona, W.J. (2012) Words of Wisdom. Re: Radical Prostatectomy versus Observation for Localized Prostate Cancer. European Urology, 62, 1195. https://doi.org/10.1016/j.eururo.2012.09.015
Cheng, J.Y. (2013) The Prostate Cancer Intervention versus Observation Trial (PIVOT) in Perspective. Journal of Clinical Medicine Research, 5, 266-268. https://doi.org/10.4021/jocmr1395w
Xia, J., Gulati, R., Au, M., Gore, J.L., Lin, D.W. and Etzioni, R. (2013) Effects of Screening on Radical Prostatectomy Efficacy: The Prostate Cancer Intervention versus Observation Trial. Journal of the National Cancer Institute, 105, 546-550. https://doi.org/10.1093/jnci/djt017
Albertsen, P.C., Hanley, J.A. and Fine, J. (2005) 20-Year Outcomes Following Conservative management of Clinically Localized Prostate Cancer. JAMA, 293, 2095-2101. https://doi.org/10.1001/jama.293.17.2095
Ross, A.E., Loeb, S., Landis, P., et al. (2010) Prostate-Specific Antigen Kinetics during Follow-Up Are an Unreliable Trigger for Intervention in a Prostate Cancer Surveillance Program. Journal of Clinical Oncology, 28, 2810-2816. https://doi.org/10.1200/JCO.2009.25.7311
Porten, S.P., Whitson, J.M., Cowan, J.E., et al. (2011) Changes in Prostate Cancer Grade on Serial Biopsy in Men Undergoing Active Surveillance. Journal of Clinical Oncology, 29, 2795-2800. https://doi.org/10.1200/JCO.2010.33.0134
Reese, A.C., Pierorazio, P.M., Han, M. and Partin, A.W. (2012) Contemporary Evaluation of the National Comprehensive Cancer Network Prostate Cancer Risk Classification System. Urology, 80, 1075-1079. https://doi.org/10.1016/j.urology.2012.07.040
Mitchell, J.A., Cooperberg, M.R., Elkin, E.P., Lubeck, D.P., Mehta, S.S., Kane, C.J. and Carroll, P.R. (2005) Ability of 2 Pretreatment Risk Assessment Methods to Predict Prostate Cancer Recurrence after Radical Prostatectomy: Data from CaPSURE. Journal of Urology, 173, 1126-1131. https://doi.org/10.1097/01.ju.0000155535.25971.de
Porten, S.P., Cooperberg, M.R. and Carroll, P.R. (2010) The Independent Value of Tumour Volume in a Contemporary Cohort of Men Treated with Radical Prostatectomy for Clinically Localized Disease. BJU International, 105, 472-475. https://doi.org/10.1111/j.1464-410X.2009.08774.x
Solomon, K., Levrel, O., Anastasiadis, A.G., et al. (2003) Prognostic Significance of Tumor Volume after Radical Prostatectomy: Amultivariate Analysis of Pathological Prognostic Factors. European Urology, 43, 39-44. https://doi.org/10.1016/S0302-2838(02)00493-1
Kikuchi, E., Scardino, P.T., Wheeler, T.M., et al. (2004) Is Tumor Volume an Independent Prognostic Factor in Clinically Localized Prostate Cancer? Journal of Urology, 172, 508-511. https://doi.org/10.1097/01.ju.0000130481.04082.1a
Nelson, B.A., Shappell, S.B., Change, S.S., et al. (2006) Tumour Volume Is an Independent Predictor of Prostate-Specific Antigen Recurrence in Patients Undergoing Radical Prostatectomy for Clinically Localized Prostate Cancer. BJU International, 97, 1169-1172. https://doi.org/10.1111/j.1464-410X.2006.06148.x
Tosoian, J.J., Trock, B.J., Landis, P., et al. (2011) Active Surveillance Program for Prostate Cancer: An Update of the Johns Hopkins Experience. Journal of Clinical Oncology, 29, 2185-2190. https://doi.org/10.1200/JCO.2010.32.8112
Klotz, L., Zhang, L., Lam, A., et al. (2010) Clinical Results of Long-Term Follow-Up of a Large, Active Surveillance Cohort with Localized Prostate Cancer. Journal of Clinical Oncology, 28, 126-131. https://doi.org/10.1200/JCO.2009.24.2180
Klotz, L. (2012) Active Surveillance: The Canadian Experience. Current Clinical Urology, 22, 222-230. https://doi.org/10.1007/978-1-61779-912-9_8
Abern, M.R., Aronson, W.J., Terris, M.K., Kane, C.J., Presti Jr., J.C., Amling, C.L. and Freedland, S.J. (2013) Delayed Radical Prostatectomy for Intermediate-Risk Prostate Cancer Is Associated with Biochemical Recurrence: Possible Implications for Active Surveillance from the SEARCH Database. The Prostate, 73, 409-417. https://doi.org/10.1002/pros.22582