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High-throughput and Comprehensive Drug Surveillance Using Multisegment Injection-Capillary Electrophoresis-Mass Spectrometry

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Active surveillance: the Canadian experience.

Laurence Klotz¹

¹Division of Urology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada. Laurence.klotz@sunnybrook.ca

Current Opinion in Urology

|March 29, 2012

Summary

Active surveillance for favorable-risk prostate cancer shows excellent long-term survival. While some patients require treatment for progression, prostate cancer mortality remains very low.

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Area of Science:

Urology
Oncology
Cancer Surveillance

Background:

Active surveillance is a standard for favorable-risk prostate cancer.
This review summarizes a prospective trial initiated in 1995.

Purpose of the Study:

To evaluate the long-term outcomes of active surveillance for prostate cancer.
To assess the rationale, methods, and results of this approach.

Main Methods:

Prospective, single-arm cohort study of 450 patients managed with expectant approach.
Intervention offered for PSA doubling time < 3 years, Gleason score progression, or clinical progression.

Main Results:

Median follow-up 6.8 years; 10-year prostate cancer survival 97.2%.
1.1% of patients died of prostate cancer; 30% reclassified to higher risk.
PSA failure rate was 50% in radically treated patients (13% of total cohort).

Conclusions:

Active surveillance demonstrates very low prostate cancer mortality.
Further research needed to identify aggressive disease in patients with favorable initial parameters.