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and cost. Key Question 5 addresses future research needs across the spectrum of Key Questions
1 through 4.

Figure 1. Analytic framework that depicts the five Key Questions (KQs) that examine the role of
active surveillance in the management of men with clinically localized prostate cancer

ADT = androgen deprivation therapy; AS = active surveillance, KQ = key question.
* ADT alone is a management strategy that is not reviewed in this review.

Literature Searches
Studies included in this review were identified through multiple literature searches using
terms relevant to prostate cancer or observational management strategies (including AS and
WW) (provided in Appendix A). Specifically, we performed a search for systematic reviews and
meta-analyses in the MEDLINE database (from 1996 through December week 4, 2010). We did
not search for systematic reviews and meta-analyses published earlier to ensure the results would
be applicable to current clinical practice. We performed an additional search of the MEDLINE
database (from inception through August, 2011) using terms for specific databases (such as the
Surveillance Epidemiology and End Results (SEER) database and the Cancer of the Prostate

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