Page 351 - An Evidence Review of Active Surveillance in Men With Localized Prostate Cancer
P. 351

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
 Freeman hospital,   Patients without   Disease progression was monitored by history, physical exam,   No treatment until   NR
 UK 141    symptoms after   TRUS for T staging and prostate volume since 1983, serum   symptomatic progression.
 [3191340]   initial outflow   acid and alkaline phosphatase and 6-monthly isotope bone
    tract surgery or   scans.
 1978-1985   biopsy.
 Hospitals in   “Localized” (bone   Patients were followed-up at 6-month intervals. All patients   Hormonal manipulation was   Bone scan for
 Manchester, UK 148    scan-negative)   underwent “multiple bone scans” (all negative), and hormonal   demanded by the protocol   metastases; PSA
 [11711356]   prostate cancer   manipulation was demanded by the protocol when the PSA   when the PSA rose to 50   levels.
    patients treated   rose to 50 ng/mL. DRE not always performed in patient with   ng/mL.
 NR   by watchful-  long-standing, stable PSA values.
 waiting. All
 patients had
 PSA level < 50
 ng/mL
 Howard University   Stage A and B   3-mo intervals for the first 5 yr, then at 4 to 6-mo intervals   Management plan of watchful   NR
 College of   prostate cancer   thereafter. Each visit assessment included DRE, pap and   waiting for most patients
 Medicine, US 138    patients who   since 1985 a PSA was done.    until signs and/or
 [1600492]   were in a   Bone scans were done initially and annually thereafter. CT of   symptoms of disease
    prospective   the pelvis was used infrequently, primarily in patients who   activity occurred.
 1967-1989   expectant   elected not to have any form of surgical therapy.    Any progressive changes in
 management                      enzymatic activity and/or
 program.                        signs or symptoms of
                                 progression or metastasis
                                 (back pains or weight loss),
                                 or changes in rectal
                                 findings either by DRE or
                                 TRUS were treated despite
                                 evidence of a positive or
                                 progression of the bone
                                 scan.



















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