Page 376 - 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
Royal Marsden AS: Fitness for WW: PSA and DRE every 6 mo WW: Symptomatic prostate NR
Hospital, UK 112 RP, T1-2, N0/X, AS: PSA and DRE every 3-6 mo for 2 yr, then every 6 mo. cancer progression
[15839912] M0/X, PSA≤20 Repeat Bx not routine. Repeat imaging only if clinically AS: Rate of rise of PSA,
ng/mL, Gleason indicated. according to judgment of
1993-2002 ≤7. “Favorable each patient and clinician.
prognostic
characteristics
and according
to patient
preference.”
WW: localized
prostate cancer
(any T stage,
N0/X, M0/X,
any PSA,
Gleason score
≤7). Unsuitable
for RP typically
because
advanced age
or
comorbidities.
Royal Mardsen T1/2a, N0/X, PSA monthly in yr 1, every 3 mo in yr 2, and every 6 mo PSA DT<4 yr, histological Gleason score >7,
Hospital, UK 124 Mo/X, PSA<15 thereafter. progression (see Definition primary Gleason
[17850368] ng/mL, Gleason DRE every 3 mo for 2 yr. of progression), or patient ≥4, (initial Gleason
≤7 (primary TRUS-guided octant biopsy at 18-24 mo preference, or PSA velocity 3+3, upgraded to
≥2002 Gleason ≤3), >1 ng/mL/yr 128 Gleason ≥3+4) 136
cancer in or ≥50% biopsy
≤50% of cores positive.
biopsy cores.
(Patients were
50-80 yr). Fit for
RP, Elected AS
for initial
treatment
SPCG-4, Finland, Patients with Followup was done every 6 mo in the first 2 yr, then every 1 yr. Adjuvant local or systemic Local progression: a
Sweden, and newly Followup included: a clinical examination, measurement of treatment was not given. transcapsular tumor
Iceland 144 diagnosed hemoglobin, creatinine, PSA, and alkaline phosphatase TURP was recommended growth was

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