TABLE II.
Active surveillance: suggested calendar for follow-up
| Follow up schedulea |
| psa, digital rectal exam every 3 months for 2 years, then every 6 months (assuming psa is stable) |
| Confirmatory 10- to 12-core biopsy within 1st year, including anterolateral horn |
| Repeat biopsy every 3–5 years until age 80 (Optional) mr imaging at baseline, or for borderline psa kinetics or pathology, or both |
| Intervention |
| When psa doubling time is less than 3 years (in most cases, based on at least 8 determinations; about 20% of patients) |
| When grade progresses to Gleason 7, with a substantial proportion of 4 pattern (about 5% of patients) |
a
These are guidelines; they should be modified according to patient age and comorbidity.
psa = prostate-specific antigen; mr = magnetic resonance.