Page 386 - 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
Univ. of Patients who WW: no additional information. Increase in tumor volume NR
Connecticut elected WW or Patients on AS were followed with PSA on an average of every (increased number or
Health Center, AS program. 6 mo. If PSA trending upward, the checks increased to every percent of cores positive),
US 108 Men on WW 3 mo depending on initial presentation and PSA trend. progression in Gleason
[18707696] were generally Rebiopsies recommended 2 yr after initial biopsy or if an score, onset of urinary
older with increased in PSA >0.75 ng/dl, a change in DRE or at patient symptoms, change in DRE
1990-2006 localized request. or patient request for
prostate cancer definitive treatment due to
who did not anxiety related to
desire increasing PSA trend.
aggressive
intervention.
Men on AS
were generally
younger with
low-risk
disease.
Univ. of Florida, Low-stage, low- Patients are followed every 3 mo with PSA and DRE annually. Cancer progresses or NR
US 149 grade disease Repeat biopsy about 6 mo after the initial diagnosis. symptoms become
[18263992] (minimal imminent.
disease on
2003-2006 biopsy), severe
medical
condition with a
life expectancy
of <10 yr, and
patient’s desire.
Univ. of Miami, Patients with DRE and PSA every 3-4 mo for 2 yr and every 6 mo Disease progression 110 Local stage
US 110 clinically subsequently. Treatment is encouraged at progression
[17850361] localized After 2000, a laterally directed and peripherally targeted TRUS an increase in tumor detected by DRE
prostate cancer biopsy of 10-12 cores was performed 9-12 mo after the first volume, Gleason score and/or biochemical
1991-2007 who elected for rebiopsy, and then every yr or earlier if there was a dramatic ≥7, or the presence of >2 progression (PSA
watchful waiting rise in PSA or a change on DRE. positive cores. increase 25-50 %/yr)
and to be or systemic
treated only progression when
when disease metastases
progressed. 127 detected. 110
No strict
guidelines for

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