Active Surveillance for Low-risk Prostate Cancer: The European Association of Urology Position in 2018

Active surveillance (AS) represents a well-recognized management option for many patients with low-and very low-risk prostate cancer (PCa). AS aims to reduce over-treatment whilst ensuring curative treatment for those in whom it is needed, without losing the window of curability. While long-term series have confirmed the safety of AS in carefully selected patients, this has resulted in new clinical questions. Can the inclusion criteria be expanded? Is there a role for biomarkers and multiparametric magnetic resonance imaging at diagnosis or during AS? What is the optimal follow-up schedule as well as the most meaningful trigger for definitive treatment? These questions, together with increasingly adopted heterogeneous protocols in AS, have prompted the European Association of Urology to produce a position paper corroborated by a summary of the scientific background on AS. Patient summary: Active surveillance (AS) is becoming a widely adopted strategy for patients affected by low-risk prostate cancer. While a formal systematic review on the topic will soon be available, the European Association of Urology has produced specific statements for different open questions on AS. (C) 2018 European Association of Urology. Published by Elsevier B.V. All rights reserved.