Abstract
The objective of this paper is to review the current recommendations for active surveillance in prostate cancer from the present prospective studies. Worldwide, there are increasing numbers of men with prostate cancer. It is now accepted as standard care that a number of men with favorable-risk disease can be followed with active surveillance. In 1995, the first prospective studies were initiated to assess the feasibility of active surveillance, in which the decision to intervene was determined by prostate-specific antigen and/or histological progression. The strategy was to provide therapy individualized to the biological behavior of the cancer. Clinical trials assessing active surveillance have usually included patients younger than 70 years of age, although the guidelines have changed over time for Gleason score and prostate-specific antigen, eg, doubling time, thereby changing the indication for active treatment. The present review focuses on patient selection, prospective studies reported in the literature, and future directions.

Prostate cancer: a review of active surveillance

Recent advances need to be highlighted in the management of both localized and metastatic prostate cancer. New early detection and molecular characterization tools are being developed to improve differentiation of their progression profiles and reduce “overdetection” and “overtreatment” of clinically “insignificant” cancers. In addition, the development of multi-parametric MR has improved the characterization of localized cancer and introduced the new concept of focal treatment. Finally, several treatments for metastatic cancer which is resistant to castration have recently increased the therapeutic armamentarium.

Prostate cancer: Review in 2014