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David D. Buethe and Julio Pow-Sang

The year 2012 marks the 10th anniversary of the initial reporting of active surveillance (AS) as a management strategy for low-risk prostate cancer. 1 , 2 Since the widespread use of prostate-specific antigen (PSA) beginning in the early 1990s

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Laurence Klotz

. Int J Radiat Oncol Biol Phys 2001 ; 50 : 615 – 620 . 19. Kakehi Y . PSA DT in Japanese active surveillance cohort (48 patients) . Jpn J Clin Oncol 2003 ; 33 : 1 – 5 . 20. Egawa S Arai Y Tobisu K . Use of pretreatment

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Simon D. Fung-Kee-Fung, Sima P. Porten, Maxwell V. Meng and Michael Kuettel

-risk disease. Active surveillance (AS) provides a management strategy in this group that may help identify men who truly need treatment and avoid treatment-related side effects in those who do not require intervention. 1 In 2010, NCCN incorporated AS into the

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James L. Mohler, Philip W. Kantoff, Andrew J. Armstrong, Robert R. Bahnson, Michael Cohen, Anthony Victor D’Amico, James A. Eastham, Charles A. Enke, Thomas A. Farrington, Celestia S. Higano, Eric Mark Horwitz, Christopher J. Kane, Mark H. Kawachi, Michael Kuettel, Timothy M. Kuzel, Richard J. Lee, Arnold W. Malcolm, David Miller, Elizabeth R. Plimack, Julio M. Pow-Sang, David Raben, Sylvia Richey, Mack Roach III, Eric Rohren, Stan Rosenfeld, Edward Schaeffer, Eric J. Small, Guru Sonpavde, Sandy Srinivas, Cy Stein, Seth A. Strope, Jonathan Tward, Dorothy A. Shead and Maria Ho

disease, can be found online at NCCN.org . Estimates of Life Expectancy Estimates of life expectancy have emerged as a key determinant of primary treatment, particularly when considering active surveillance or observation. Although estimating life

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David Y. T. Chen and Robert G. Uzzo

Edited by Kerrin G. Robinson

during active surveillance . J Urol 2007 ; 177 : 849 – 853 ; discussion 853–844 . 41 Kunkle DA Egleston BL Uzzo RG . Excise, ablate or observe: the small renal mass dilemma—a meta-analysis and review . J Urol 2008 ; 179 : 1227 – 1233

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Ayal A. Aizer, Jonathan J. Paly, Anthony L. Zietman, Paul L. Nguyen, Clair J. Beard, Sandhya K. Rao, Irving D. Kaplan, Andrzej Niemierko, Michelle S. Hirsch, Chin-Lee Wu, Aria F. Olumi, M. Dror Michaelson, Anthony V. D’Amico and Jason A. Efstathiou

active surveillance to be a standard option for all men with very-low-risk prostate cancer, and the only option for men with very-low-risk prostate cancer and an expected survival of less than 20 years. Under an active surveillance regimen, immediate

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Ayal A. Aizer, Xiangmei Gu, Ming-Hui Chen, Toni K. Choueiri, Neil E. Martin, Jason A. Efstathiou, Andrew S. Hyatt, Powell L. Graham, Quoc-Dien Trinh, Jim C. Hu and Paul L. Nguyen

is often overtreated in the United States, as the 10-year disease-specific mortality rate for appropriately selected patients managed with active surveillance approaches 0%, 3 – 5 and a recently published randomized clinical trial showed no survival

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Ghadeer Olleik, Wassim Kassouf, Armen Aprikian, Jason Hu, Marie Vanhuyse, Fabio Cury, Stuart Peacock, Elin Bonnevier, Ebba Palenius and Alice Dragomir

need immediate treatment, up to 60% of patients diagnosed with PCa according to current practice can be managed safely with active surveillance (AS). 16 Thus, significant efforts have been made to find new tests and interventions that can differentiate

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Ashley E. Ross

or pT3 disease at radical prostatectomy. Oncotype DX is intended to evaluate biopsies in men with low- or low-intermediate–risk disease managed on active surveillance. The performance of Oncotype DX has not yet been reported in active surveillance

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James Mohler, Robert R. Bahnson, Barry Boston, J. Erik Busby, Anthony D'Amico, James A. Eastham, Charles A. Enke, Daniel George, Eric Mark Horwitz, Robert P. Huben, Philip Kantoff, Mark Kawachi, Michael Kuettel, Paul H. Lange, Gary MacVicar, Elizabeth R. Plimack, Julio M. Pow-Sang, Mack Roach III, Eric Rohren, Bruce J. Roth, Dennis C. Shrieve, Matthew R. Smith, Sandy Srinivas, Przemyslaw Twardowski and Patrick C. Walsh

surveillance (see Principles of Active Surveillance, page 180). Although estimating life expectancy for groups of men is possible, extrapolating these estimates to individual patients is more difficult. Life expectancy can be estimated using the Minnesota