Role of the pathologist in active surveillance for prostate cancer

Active surveillance (AS) is an alternative strategy that aims to minimize overtreatment by selecting only patients with significant prostate cancer (PCa) tumors for immediate treatment. Patients with favorable tumor characteristics are closely monitored using serum prostate-specific antigen (PSA) levels and serial biopsies of the prostate. In addition, other predictors of tumor progression, such as PSA doubling time, can be used during AS management. AS represents an excellent opportunity to identify molecular biomarkers of PCa behavior and to develop novel therapeutic strategies.