Is There a Role for Active Surveillance in Low-Risk Prostate Cancer?

Background: Active surveillance (AS) represents an expectant treatment strategy for clinically localized prostate cancer (PCa) with low-risk features. Objective: The actual management as well as the pros and cons of AS were evaluated. Methods: A systematic review of the recent literature was performed using the Medline databases. Conclusions: Since a substantial number of men die with rather than from PCa, there is a considerable role for AS in carefully selected men. AS may also represent a strategy to reduce the burden of overtreatment rooted in intensified PSA testing. Facing the imprecision of risk stratification based on transrectal ultra-sound- guided biopsy, accurate clinical staging represents a major medical challenge. Counseling and care require empathy as well as a profound understanding of the biology and the natural history of PCa. (C) 2015 S. Karger AG, Basel