title: Active surveillance in low-risk prostate cancer. Patient acceptance and results.
abstract: OBJECTIVE
  To evaluate the acceptance of active monitoring by patients treated in our healthcare community and to report the clinical results of an active surveillance program in patients with low-risk prostate cancer.
  
  
  METHODS
  Prospective study of patients enrolled in an active surveillance programme at our centre between 2004 and 2012. The inclusion criteria were PSA <10 ng/ml, Gleason score ≤6, clinical stage T1c/T2a, ≤2 positive cores, and no more than 50% of the core being affected. Curative treatment was proposed when faced with pathological progression over the course of the monitoring.
  
  
  RESULTS
  In 2011, only 17% of the total number of potential candidate patients rejected their inclusion in a surveillance programme and were treated actively. We analysed a series of 144 patients included in our active surveillance protocol. The mean follow-up time was 3.22 years (SD 2.08). A total of 110 patients (76.3%) remained under active monitoring, with an estimated median treatment-free survival after diagnosis of 6.9 years (95% CI: 6.2-7.6). The percentage of patients who remained free of treatment at 2 and 5 years was 96.3% (95% CI: 92.8%-99.8%) and 70.9% (95% CI: 59.3%-85.5%), respectively. Thirty four patients (23.6%) required curative treatment. The mean time to treatment was 4.6 years (SD 2.3).
  
  
  CONCLUSIONS
  Active surveillance of highly selected patients with low-risk prostate cancer is a valid alternative therapy that is accepted by patients in our community.
authors.affiliation: Servicio de Urología, Hospital Universitario Fundación de Alcorcón, Madrid, España. Electronic address: vhernandez@fhalcorcon.es.
authors.forename: V
authors.initials: V
authors.lastname: Hernández
authors.forename: C
authors.initials: C
authors.lastname: Blázquez
authors.forename: E
authors.initials: E
authors.lastname: de la Peña
authors.forename: E
authors.initials: E
authors.lastname: Pérez-Fernández
authors.forename: F J
authors.initials: FJ
authors.lastname: Díaz
authors.forename: C
authors.initials: C
authors.lastname: Llorente
mesh_terms: D000230:Adenocarcinoma / Q000628:therapy*; D000368:Aged; D006801:Humans; D008297:Male; D010349:Patient Compliance; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000628:therapy*; D018570:Risk Assessment; D016896:Treatment Outcome; D057832:Watchful Waiting
keywords: Active surveillance; Cáncer de próstata; Prostate cancer; Resultados del tratamiento; Treatment results; Vigilancia activa