Active surveillance of organ-confined prostate cancer

The treatment strategy of "active surveillance" with selective but delayed intervention for patients with organ-confined prostate cancers could be an attractive alternative to the known curative options of radical prostatectomy or radiotherapy. The increasing demand of patients and doctors, however, stands in contrast to a rather sparse data basis for this approach in prospective studies. It remains unclear which patients should be selected for the approach and at which point the strategy of "active surveillance" should be stopped and converted to active treatment interventions. As long as these important data are missing from the currently running prospective trials, the treatment strategy of "active surveillance" should be recommended with caution and for strictly selected patients only. The follow-up regimens with biopsy and PSA should consist of frequent visits and close observations of these parameters.