Abstract

Objective: Active surveillance has become a management option for low-risk prostate cancer patients, while keeping the curative treatment option available. In this study, we evaluated the results of active surveillance for localized prostate cancer patients.

Material and methods: Patients diagnosed with localized prostate cancer who chose an active surveillance protocol were followed with PSA measurements, digital rectal examinations and TRUS-guided biopsies. The patients’ data and re-biopsy results were evaluated. The results were compared with the results of the patients who had definitive treatment.

Results: Forty-one patients on active surveillance and 34 patients with at least one re-biopsy were included in the study. Twenty-seven patients who had more than one re-biopsy were followed for an average of 27.7 (12-78) months. Twelve patients (44.4%) had definitive treatment: 9 had a radical prostatectomy, and 3 had radiotherapy. There were 17 patients under surveillance after a second biopsy, and 9 (33%) of them had a third biopsy. Among these 9 patients, 7 patients were kept under surveillance, and 2 (7%) of those had a fourth biopsy. The follow-up of 15 of 17 patients who have not undergone definitive treatment is still ongoing.

Conclusion: Active surveillance is a treatment option that protects low-risk prostate cancer patients from the complications of or a reduction in the quality of life due to an early or unnecessary definitive treatment option, while keeping the curative treatment option available. Active surveillance can be applied safely with the appropriate patient selection, regular examinations and tests.