BACKGROUND: Active surveillance (AS) is a recognised treatment option for low-risk prostate cancer (PCa). AIMS: To review AS criteria in terms of patient selection, follow-up and indications for intervention. METHODS: A total of 2,959 potential participants were identified and invited via email to complete an online survey. Only urologists practising in an EU country were eligible to participate. Statistical analyses were carried out using SPSS version 18.0. The χ (2) test was used to compare responses between those who do and do not follow an AS protocol. RESULTS: Response rate was 8% (n = 226). Ninety-seven per cent urologists offer AS; 25% (n = 53/215) within a clinical trial and a further 28% (n = 60/215) using an official AS protocol. Gleason score ≤ 3 + 3 = 6 (87 %, n = 173/200) and prostate-specific antigen (PSA) ≤ 10 ng/ml (86%, n = 170/198) are the commonest selection criteria. There was a statistically significant association between having an AS protocol and using PSA as an eligibility criterion (p = 0.03). For urologists not following a protocol, 11% do not consider PSA as an eligibility criterion and 81% consider PSA ≤ 10 ng/ml to decide on AS, compared to 2 and 90%, respectively, who adhere to a protocol. Twenty-four per cent of urologists without a protocol do not re-biopsy in comparison to 11% with a protocol (p = 0.026). Gleason score progression trigger the most intervention (n = 168/192, 87%). CONCLUSIONS: Urologists not adhering to an AS protocol or participating in a clinical trial appear to apply less rigorous criteria for both eligibility and monitoring in AS.
BACKGROUND: Active surveillance (AS) is a recognised treatment option for low-risk prostate cancer (PCa). AIMS: To review AS criteria in terms of patient selection, follow-up and indications for intervention. METHODS: A total of 2,959 potential participants were identified and invited via email to complete an online survey. Only urologists practising in an EU country were eligible to participate. Statistical analyses were carried out using SPSS version 18.0. The χ (2) test was used to compare responses between those who do and do not follow an AS protocol. RESULTS: Response rate was 8% (n = 226). Ninety-seven per cent urologists offer AS; 25% (n = 53/215) within a clinical trial and a further 28% (n = 60/215) using an official AS protocol. Gleason score ≤ 3 + 3 = 6 (87 %, n = 173/200) and prostate-specific antigen (PSA) ≤ 10 ng/ml (86%, n = 170/198) are the commonest selection criteria. There was a statistically significant association between having an AS protocol and using PSA as an eligibility criterion (p = 0.03). For urologists not following a protocol, 11% do not consider PSA as an eligibility criterion and 81% consider PSA ≤ 10 ng/ml to decide on AS, compared to 2 and 90%, respectively, who adhere to a protocol. Twenty-four per cent of urologists without a protocol do not re-biopsy in comparison to 11% with a protocol (p = 0.026). Gleason score progression trigger the most intervention (n = 168/192, 87%). CONCLUSIONS: Urologists not adhering to an AS protocol or participating in a clinical trial appear to apply less rigorous criteria for both eligibility and monitoring in AS.
Authors: Ian Thompson; James Brantley Thrasher; Gunnar Aus; Arthur L Burnett; Edith D Canby-Hagino; Michael S Cookson; Anthony V D'Amico; Roger R Dmochowski; David T Eton; Jeffrey D Forman; S Larry Goldenberg; Javier Hernandez; Celestia S Higano; Stephen R Kraus; Judd W Moul; Catherine M Tangen Journal: J Urol Date: 2007-06 Impact factor: 7.450
Authors: A V D'Amico; R Whittington; S B Malkowicz; J Fondurulia; M H Chen; I Kaplan; C J Beard; J E Tomaszewski; A A Renshaw; A Wein; C N Coleman Journal: J Clin Oncol Date: 1999-01 Impact factor: 44.544
Authors: Axel Heidenreich; Joaquim Bellmunt; Michel Bolla; Steven Joniau; Malcolm Mason; Vsevolod Matveev; Nicolas Mottet; Hans-Peter Schmid; Theo van der Kwast; Thomas Wiegel; Filliberto Zattoni Journal: Eur Urol Date: 2010-10-28 Impact factor: 20.096
Authors: Jeffrey J Tosoian; Bruce J Trock; Patricia Landis; Zhaoyong Feng; Jonathan I Epstein; Alan W Partin; Patrick C Walsh; H Ballentine Carter Journal: J Clin Oncol Date: 2011-04-04 Impact factor: 44.544
Authors: Matthew R Cooperberg; David J Pasta; Eric P Elkin; Mark S Litwin; David M Latini; Janeen Du Chane; Peter R Carroll Journal: J Urol Date: 2005-06 Impact factor: 7.450
Authors: Marc A Dall'Era; Peter C Albertsen; Christopher Bangma; Peter R Carroll; H Ballentine Carter; Matthew R Cooperberg; Stephen J Freedland; Laurence H Klotz; Christopher Parker; Mark S Soloway Journal: Eur Urol Date: 2012-06-07 Impact factor: 20.096
Authors: Scott E Eggener; Alex Mueller; Ryan K Berglund; Raj Ayyathurai; Cindy Soloway; Mark S Soloway; Robert Abouassaly; Eric A Klein; Steven J Jones; Chris Zappavigna; Larry Goldenberg; Peter T Scardino; James A Eastham; Bertrand Guillonneau Journal: J Urol Date: 2009-02-23 Impact factor: 7.450
Authors: David M Latini; Stacey L Hart; Sara J Knight; Janet E Cowan; Phillip L Ross; Janeen Duchane; Peter R Carroll Journal: J Urol Date: 2007-07-16 Impact factor: 7.450
Authors: Kittie Pang; Margaret Fitch; Veronique Ouellet; Simone Chevalier; Darrel E Drachenberg; Antonio Finelli; Jean-Baptiste Lattouf; Alan So; Simon Sutcliffe; Simon Tanguay; Fred Saad; Anne-Marie Mes-Masson Journal: BMC Health Serv Res Date: 2018-06-08 Impact factor: 2.655
Authors: Sophie M Bruinsma; Chris H Bangma; Peter R Carroll; Michael S Leapman; Antti Rannikko; Neophytos Petrides; Mahesha Weerakoon; Leonard P Bokhorst; Monique J Roobol Journal: Nat Rev Urol Date: 2016-01-27 Impact factor: 14.432