Page 382 - An Evidence Review of Active Surveillance in Men With Localized Prostate Cancer
P. 382

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
                                                                Klotz 2010: 125                                                                            had to be <3 yr. Later PSA        satisfied: PSA DT
                                                                Between 1995                                                                               DT was calculated by              <2 yr, based on at
                                                                and 1999, study                                                                            physicians who used PSA           least 3 separate
                                                                was offered to                                                                             fluctuations to determine         measurements over
                                                                low-risk patients                                                                          whether PSA DT was                a minimum of 6 mo;
                                                                (Gleason ≤6 or                                                                             “truly” <3 yr. In 2005 the        final PSA >8 ng/ml;
                                                                less, PSA ≤10                                                                              group developed a general         p-value <0.05 from
                                                                ng/ml) and to                                                                              linear mixed model as a           regression of
                                                                patients older                                                                             clinical decision making          ln(PSA) on time.
                                                                                                                                                               o
                                                                than 70 yr old                                                                             aid.                            Additional information
                                                                with PSA <15                                                                                                                 on biopsy frequency
                                                                ng/ml or                                                                                                                     during followup,
                                                                Gleason ≤3+4.                                                                                                                reported in Klotz
                                                                                                                                                                                                  125
                                                                Since January                                                                                                                2010     and      129
                                                                2000, the study                                                                                                              Krakowsky 2010:
                                                                was restricted                                                                                                               Subsequent
                                                                to low-risk                                                                                                                  biopsies were
                                                                patients only.                                                                                                               performed every 3-4
                                                                                                                                                                                             yr to identify biologic
                                                                                                                                                                                             progression.
                                                                                                                                                                                             Patients with
                                                                                                                                                                                             borderline PSA DT
                                                                                                                                                                                             underwent biopsies
                                                                                                                                                                                             more frequently.
                                                                                                                                                                                             Between 1995 and
                                                                                                                                                                                             2000 sextant
                                                                                                                                                                                             biopsies were used;
                                                                                                                                                                                             since 2000, 10 to
                                                                                                                                                                                             14-core biopsies
                                                                                                                                                                                             were performed
                                                                                                                                                                                             using the Vienna
                                                                                                                                                                                             nomogram.
















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