To determine if the practice of active surveillance for prostate cancer (PCa) at the District General Hospital (DGH) level produces outcomes in keeping with those published from clinical trials.
Subjects
A cohort of 47 patients started on active surveillance for prostate cancer in 2002–2003.
Methods
Retrospective review of case notes, electronic records and the regional cancer register.
Results
This cohort of patients had significantly higher disease-specific mortality and greater progression to palliative forms of management compared to previously published studies.
Conclusion
The implementation of AS in routine clinical practice may be inconsistent, potentially leading to compromised patient outcomes.
National Institute for Health and Clinical Excellence (2008) Prostate cancer: diagnosis and treatment (CG58).London: National Institute for Health and Care Excellence. [http://www.nice.org.uk/ourguidance/reference.jsp; Accessed, 4/7/2013].
2.
HeidenreichA, BellmuntJ, BollaM, MatveevV. EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and treatment of clinically localised disease.Eur Urol2011; 59: 61–71.
3.
Guideline for the management of clinically localized prostate cancer: 2007 update.American Urological Association, 2007.
4.
KlotzL, ZhangL, LamA. Clinical results of long-term follow-up of a large, active surveillance cohort with localized prostate cancer.J Clin Oncol2010; 28: 126–131.
5.
MiocinovicR, JonesJS, PujaraAC. Acceptance and durability of surveillance as a management choice in men with screen-detected, low-risk prostate cancer: Improved outcomes with stringent enrolment criteria.Urology2011; 77: 980–984.
6.
Dall'EraMA, KonetyBR, CowanJE. Active surveillance for the management of prostate cancer in a contemporary cohort.Cancer2008; 112: 2664–2670.
7.
van den BerghRC, RoemelingS, RoobolMJ. Outcomes of men with screen-detected prostate cancer eligible for active surveillance who were managed expectantly.Eur Urol2009; 55: 1–8.
8.
van AsNJ, NormanAR, ThomasK. Predicting the probability of deferred radical treatment for localised prostate cancer managed by active surveillance.Eur Urol2008; 54: 1297–1305.
9.
SolowayMS, SolowayCT, EldefrawyA. Careful selection and close monitoring of low-risk prostate cancer patients on active surveillance minimizes the need for treatment.Eur Urol2010; 58: 831–835.
10.
TosoianJJ, TrockBJ, LandisP. Active surveillance program for prostate cancer: An update of the Johns Hopkins experience.J Clin Oncol2011; 29: 2185–2190.
11.
AdamyA, YeeDS, MatsushitaK. Role of prostate specific antigen and immediate confirmatory biopsy in predicting progression during active surveillance for low risk prostate cancer.J Urol2011; 185: 477–482.
12.
Al OtaibiM, RossP, FahmyN. Role of repeated biopsy of the prostate in predicting disease progression in patients with prostate cancer on active surveillance.Cancer2008; 113: 286–292.
13.
RossAE, LoebS, LandisP. Prostate-specific antigen kinetics during follow-up are an unreliable trigger for intervention in a prostate cancer surveillance program.J Clin Oncol2010; 28: 2810–2816.
