Table 1.

Institutional Active Surveillance Protocols

Institutional Protocols	Cohort Size	Mean Follow-up (months)	Eligibility Criteria	Follow-up Methods	Disease Progression	Predictors	% Intervention	OS (%)	CSS (%)
Johns Hopkins [46]	769	32	•≤ Clinical T1c	•PSA/DRE every 6 months	•GS > 6	n/a	33.2% at a median of 26 months (26% treated for personal choice without disease progression)	98	100
			•PSAD < 0.15 ng/mL2	•Biopsy yearly	•# of Positive cores > 2
			•GS ≤ 6		•> 50% cancer involvement of any core
			•# of Positive cores ≤ 2
			•≤ 50% cancer involvement of any core
UCSF [23]	321	43	•≤ Clinical T1/T2a	•PSA/DRE every 3 months	•Increase in Gleason grade on rebiopsy	•Initial PSAD ≥ 0.15 ng/mL2	24% at a median of 36 months after diagnosis (33% treated for personal choice without disease progression)	100	100
			•PSA < 10	•Biopsy every 6-12 months (starting 2003, repeat biopsies at 12-24 months)	•Increase in PSAV of > 0.75 ng/mL/year	•Increase in Gleason grade on rebiopsy
			•GS ≤ 6 without grade 4 or 5		•PSADT < 2 years
			•cancer involvement < 33% of biopsy cores
Univ. of Miami [51]	230	44	•PSA ≤ 10	•PSA/DRE every 3-4 months for 2 years then every 6 months	•Gleason grade > 3 on rebiopsy	•Any tumor at the first rebiopsy	14% in a mean follow-up of 33 months	100	100
			•GS ≤ 6	•Biopsy in 9-12 months then yearly	•Increase in positive number of cores
			•# of Positive cores ≤ 2		•Increase in % of tumor in each core
			•≤ 20% cancer involvement of any core
Univ. of Toronto [26]	450	82	•PSA ≤ 10	•PSA every 3 months for 2 years then every 6 months	•PSADT < 3 years (initially used PSADT < 2 years up until 1999)	•PSAD	30% overall (58% of men in the initial intermediate-risk group were treated)	79	97.2
			•GS ≤ 6	•Biopsy in 6-12 months then every 3-4 years until age 80	•Increase in Gleason grade on rebiopsy	•Gleason score at baseline > 6
			•(initially included PSA ≤ 15 and GS 3+4 on men age ≥ 70 up until Jan, 2000)		•Clinical progression	•Clinical stage at baseline > T2a
MSK [52,53]	238	22	•≤ Clinical T2a	•PSA/DRE every 6 months	•When eligibility criteria was no longer met	•Any tumor at the first rebiopsy	n/a	n/a	n/a
			•PSA < 10	•Biopsy in 12-18 months then every 2-3 years
			•GS ≤ 6 without grade 4 or 5
			•# of Positive core ≤ 2
			•≤ 50% cancer involvement of any core
Royal Marsden [50]	326	22	•≤ Clinical T2a	•PSA monthly for year 1 then every 3 months in year 2 then every 6 months	•PSAV > 1 ng/mL/year	•Free-to-total PSA ratio	20%	98	100
			•PSA ≤ 15	•DRE every 3 months for 2 years then every 6 months	•Primary Gleason grade ≥ 4	•Clinical stage
			•GS ≤ 7 with primary grade ≤ 3	•Biopsy at 18-24 months then every 2 years	•% Positive biopsy core > 50%
			•≤ 50% cancer involvement of any core
PRIAS [54]	2494	19	•≤ Clinical T2	•PSA every 3 months for 2 years then every 6 months	•GS > 6	•PSAD	21%	97	100
			•PSA ≤ 10	•Biopsy at year 1,4 and 7	•PSADT < 3 years after at least 1 year of follow-up	•Number of positive cores (2 vs. 1)
			•GS ≤ 6	•Yearly biopsies if PSADT between 3-10 years	•≥ 3 positive biopsy cores
			•PSAD < 0.2 ng/mL2
			•# of Positive cores ≤ 2
NCCN [64]	n/a	n/a	•≤ Clinical T1c (T2a with < 10 yr life-expectancy)	•PSA every 6 months	•Gleason grade > 3	n/a	n/a	n/a	n/a
			•PSA < 10	•DRE every 12 months	•Increase in positive number of cores
			•GS ≤ 6	•Biopsy as often as every 12 months	•Increase in % of tumor in each core
			•PSAD < 0.15 ng/mL2
			•# of positive cores ≤ 2
			•≤ 50% cancer involvement of any core

UCSF=Univ. of California–San Francisco, MSK=Memorial Sloan-Kettering, PRIAS=Prostate Cancer Research International: Active Surveillance, NCCN=National Comprehensive Cancer Network, PSA=prostate-specific antigen, GS=Gleason score, PSAD=prostate-specific antigen density, DRE=digital rectal exam, PSADT=prostate-specific antigen doubling time, PSAV=prostate-specific antigen velocity, OS=Overall Survival, CSS=Cancer-Specific Survival.