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


Journal Article (Review)

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.

Full Text

Duke Authors

Cited Authors

  • Dall'Era, MA; Cooperberg, MR; Chan, JM; Davies, BJ; Albertsen, PC; Klotz, LH; Warlick, CA; Holmberg, L; Bailey, DE; Wallace, ME; Kantoff, PW; Carroll, PR

Published Date

  • April 2008

Published In

Volume / Issue

  • 112 / 8

Start / End Page

  • 1650 - 1659

PubMed ID

  • 18306379

Pubmed Central ID

  • 18306379

Electronic International Standard Serial Number (EISSN)

  • 1097-0142

International Standard Serial Number (ISSN)

  • 0008-543X

Digital Object Identifier (DOI)

  • 10.1002/cncr.23373


  • eng