Page 345 - An Evidence Review of Active Surveillance in Men With Localized Prostate Cancer

Appendix Table C2.1. Eligibility criteria, follow-up protocols, triggers for intervention and definition of progression in cohorts of active
surveillance/ watchful waiting/other observational management strategies (continued)

Center, Country Eligibility criteria Followup or monitoring protocol Triggers for intervention/ Definition of
[PMID] active therapy progression
Enrollment year
Dana-Farber Clinically localized disease (T1c- PSA and DRE every 6 mo, and 20-core biopsy Patients with progression Progression criteria: 1)
Cancer Institute, T2c), Gleason score 6 or less every 12 to 18 mo were offered surgery or 3 or more positive
US 117 with no pattern 4, <3 cores Protocol with cure intent. radiotherapy. cores, 2) increased
[21167525] positive for cancer and no grade (Gleason
more than 50% of cancer in score 7 or greater)
2000-2010 any core. and/or 3) more than
No age, PSA values or PSA 50% of any core
density exclusion criteria was involved with
used. cancer.
Erasmus Univ. Histologically Usually followed clinically twice yearly (mean 2.7 annual visits, Subjective progression, like Local progression:
hospital, confirmed range 1.4 to 4.3) for physical exam including DRE and serum obstructive micturition or symptomatic,
Netherlands 145 cancer; PSA and alkaline phosphatase levels. Bone scan and chest x- pain, was considered for increase in T
[7544841] Metastatic ray were repeated regularly and when clinically indicated. treatment decisions. 145 category, increase in
disease was Follow-up regimens varied among local practices, data for this prostate size on
≤1990; 1993- excluded by a study were collected from chart reviews of medical history, Note: The authors reported DRE by 25%, or
2006 150 normal chest x- DRE, dissemination studies, and PSA tests. 150 that of 13 patients with increase in
ray and a progression, 6 started ultrasound
normal bone treatment (5 for subjective measured volume
scan. symptoms; 1 for objective >40%.
The decision not progression only). The Metastatic
to treat was authors also reported that progression: new
made by the PSA progression may bone lesion.
urologist in serve as a trigger point to
discussion with treatment. 150
the patient and
his family, with
respect to
patient age,
general health,
clinical stage
and patient
preference. All
patients had
estimated
survival >1 yr.
Men on AS who
were detected
within the
screening

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