The American Society of Clinical Oncology (ASCO) endorsed Cancer Care Ontario’s guideline on Active Surveillance for the Management of Localized Prostate Cancer.1
The guidelines stated that for most patients with low-risk localized prostate cancer, defined as Gleason score ≤ 6, active surveillance should be the recommended disease management strategy. Patients with low-volume, intermediate-risk prostate cancer, defined as Gleason score of 3 + 4 = 7, may be offered active surveillance.
Active surveillance includes testing for prostate-specific antigen levels, digital rectal examinations, and serial prostate biopsies.
Patients with discordant clinical and/or pathological findings may receive ancillary radiologic and genomic tests, although they remain investigational.
Patients with a higher-risk category disease, defined as a Gleason score ≥ 7, or who have significant increased tumor volume on subsequent biopsies, should be given active therapy.
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ASCO’s Endorsement Panel determined that the recommendations were clear, thorough, and based on the most relevant scientific evidence, although The Cancer Care Ontario recommendation regarding 5-alpha reductase inhibitors was not included in the endorsement.
- Chen RC, Rumble B, Loblaw DA, et al. Active surveillance for the management of localized prostate cancer (Cancer Care Ontario Guideline): American Society of Clinical Oncology Clinical Practice Guideline endorsement [published online ahead of print February 16, 2016]. J Clin Oncol. doi: 10.1200/JCO.2015.65.7759.