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Patient Selection for Active Surveillance

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Active Surveillance for Localized Prostate Cancer

Part of the book series: Current Clinical Urology ((CCU))

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Abstract

Due to a long natural history, the majority of men diagnosed with prostate cancer in the current era would never die of disease if left untreated. Unfortunately, a potentially lethal tumor cannot be reliably distinguished from an insignificant tumor with certainty. As a result, urologists have developed strategies to monitor carefully selected men with favorable risk prostate cancer, with curative intervention in the event of disease progression: active surveillance. This chapter focuses on the selection of appropriate candidates for active surveillance.

The goal of patient selection is to identify all patients with a nonlethal phenotype while excluding those who harbor the lethal phenotype. Use of clinical and pathological factors assists in determining patients with favorable risk, though these strategies are imperfect. Evidence from active surveillance cohorts, large cancer registries, and randomized controlled trials has clarified the risk of prostate cancer-specific mortality based on risk profile, age, and life expectancy and has been utilized by recent guidelines from the National Comprehensive Cancer Network. In this chapter, we will discuss the heterogeneous natural history of prostate cancer, strategies for determining risk of prostate cancer-specific mortality, and the limitations of the current paradigm. For carefully selected men, active surveillance may preserve a patient’s quality of life with minimal risk of harm from cancer.

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References

  1. Jemal A, Siegel R, Xu J, Ward E. Cancer statistics, 2010. CA Cancer J Clin. 2010 Sep–Oct;60(5):277–300.

    Article  PubMed  Google Scholar 

  2. Soos G, Tsakiris I, Szanto J, Turzo C, Haas PG, Dezso B. The prevalence of prostate carcinoma and its precursor in Hungary: an autopsy study. Eur Urol. 2005 Nov;48(5):739–44.

    Article  PubMed  Google Scholar 

  3. Sakr WA, Haas GP, Cassin BF, Pontes JE, Crissman JD. The frequency of carcinoma and intraepithelial neoplasia of the prostate in young male patients. J Urol. 1993 Aug;150(2 Pt 1):379–85.

    PubMed  CAS  Google Scholar 

  4. Cooperberg MR, Broering JM, Carroll PR. Time trends and local variation in primary treatment of localized prostate cancer. J Clin Oncol. 2010 Mar 1;28(7):1117–23.

    Article  PubMed  Google Scholar 

  5. Hamilton AS, Albertsen PC, Johnson TK, et al. Trends in the treatment of localized prostate cancer using supplemented cancer registry data. BJU Int. 2011 Feb;107(4):576–84.

    Article  PubMed  Google Scholar 

  6. Bechis SK, Carroll PR, Cooperberg MR. Impact of age at diagnosis on prostate cancer treatment and survival. J Clin Oncol. 2010 Jan 10;29(2):235–41.

    Article  PubMed  Google Scholar 

  7. Schroder FH, Hugosson J, Roobol MJ, et al. Screening and prostate-cancer mortality in a randomized European study. N Engl J Med. 2009 Mar 26;360(13):1320–8.

    Article  PubMed  Google Scholar 

  8. Hugosson J, Carlsson S, Aus G, et al. Mortality results from the Goteborg randomised population-based prostate-cancer screening trial. Lancet Oncol. 2010 Aug;11(8):725–32.

    Article  PubMed  Google Scholar 

  9. Etzioni R, Penson DF, Legler JM, et al. Overdiagnosis due to prostate-specific antigen screening: lessons from U.S. prostate cancer incidence trends. J Natl Cancer Inst. 2002 Jul 3;94(13):981–90.

    Article  PubMed  Google Scholar 

  10. Draisma G, Boer R, Otto SJ, et al. Lead times and overdetection due to prostate-specific antigen screening: estimates from the European Randomized Study of Screening for Prostate Cancer. J Natl Cancer Inst. 2003 Jun 18;95(12):868–78.

    Article  PubMed  Google Scholar 

  11. Loeb S, Vonesh EF, Metter EJ, Carter HB, Gann PH, Catalona WJ. What is the true number needed to screen and treat to save a life with prostate-specific antigen testing? J Clin Oncol. 2011 Feb 1;29(4):464–7.

    Article  PubMed  Google Scholar 

  12. Klotz L. Active surveillance for prostate cancer: for whom? J Clin Oncol. 2005 Nov 10;23(32):8165–9.

    Article  PubMed  Google Scholar 

  13. Shao YH, Albertsen PC, Roberts CB, et al. Risk profiles and treatment patterns among men diagnosed as having prostate cancer and a prostate-specific antigen level below 4.0 ng/ml. Arch Intern Med. 2010 Jul 26;170(14):1256–61.

    Article  PubMed  Google Scholar 

  14. Tosoian JJ, Loeb S, Kettermann A, et al. Accuracy of PCA3 measurement in predicting short-term biopsy progression in an active surveillance program. J Urol. 2010 Feb;183(2):534–8.

    Article  PubMed  CAS  Google Scholar 

  15. Deras IL, Aubin SM, Blase A, et al. PCA3: a molecular urine assay for predicting prostate biopsy outcome. J Urol. 2008 Apr;179(4):1587–92.

    Article  PubMed  Google Scholar 

  16. Woodson K, O’Reilly KJ, Hanson JC, Nelson D, Walk EL, Tangrea JA. The usefulness of the detection of GSTP1 methylation in urine as a biomarker in the diagnosis of prostate cancer. J Urol. 2008 Feb;179(2):508–11; discussion 11–2.

    Article  PubMed  CAS  Google Scholar 

  17. Vickers AJ, Gupta A, Savage CJ, et al. A panel of kallikrein marker predicts prostate cancer in a large, population-based Cohort followed for 15 years without screening. Cancer Epidemiol Biomarkers Prev. 2011 Mar;20(2):255–61.

    Article  PubMed  CAS  Google Scholar 

  18. Perner S, Hofer MD, Kim R, et al. Prostate-specific membrane antigen expression as a predictor of prostate cancer progression. Hum Pathol. 2007 May;38(5):696–701.

    Article  PubMed  CAS  Google Scholar 

  19. Gallagher DJ, Gaudet MM, Pal P, et al. Germline BRCA mutations denote a clinicopathologic subset of prostate cancer. Clin Cancer Res. 2010 Apr 1;16(7):2115–21.

    Article  PubMed  CAS  Google Scholar 

  20. Mani RS, Tomlins SA, Callahan K, et al. Induced chromosomal proximity and gene fusions in prostate cancer. Science. 2009 Nov 27;326(5957):1230.

    Article  PubMed  CAS  Google Scholar 

  21. Cuzick J, Swanson GP, Fisher G, et al. Prognostic value of an RNA expression signature derived from cell cycle proliferation genes in patients with prostate cancer: a retrospective study. Lancet Oncol. 2011 Mar;12(3):245–55.

    Article  PubMed  CAS  Google Scholar 

  22. Ding Z, Wu CJ, Chu GC, et al. SMAD4-dependent barrier constrains prostate cancer growth and metastatic progression. Nature. 2011 Feb 10;470(7333):269–73.

    Article  PubMed  CAS  Google Scholar 

  23. Albertsen PC, Hanley JA, Fine J. 20-year outcomes following conservative management of clinically localized prostate cancer. JAMA. 2005 May 4;293(17):2095–101.

    Article  PubMed  CAS  Google Scholar 

  24. Albertsen PC, Hanley JA, Barrows GH, et al. Prostate cancer and the Will Rogers phenomenon. J Natl Cancer Inst. 2005 Sep 7;97(17):1248–53.

    Article  PubMed  Google Scholar 

  25. Lu-Yao GL, Albertsen PC, Moore DF, et al. Outcomes of localized prostate cancer following conservative management. JAMA. 2009 Sep 16;302(11):1202–9.

    Article  PubMed  CAS  Google Scholar 

  26. Stattin P, Holmberg E, Johansson JE, Holmberg L, Adolfsson J, Hugosson J. Outcomes in localized prostate cancer: National Prostate Cancer Register of Sweden follow-up study. J Natl Cancer Inst. 2010 Jul 7;102(13):950–8.

    Article  PubMed  Google Scholar 

  27. Bill-Axelson A, Holmberg L, Filen F, et al. Radical prostatectomy versus watchful waiting in localized prostate cancer: the Scandinavian prostate cancer group-4 randomized trial. J Natl Cancer Inst. 2008 Aug 20;100(16):1144–54.

    Article  PubMed  Google Scholar 

  28. Mohler J, Bahnson RR, Boston B, et al. NCCN clinical practice guidelines in oncology: prostate cancer. J Natl Compr Canc Netw. 2010 Feb;8(2):162–200.

    PubMed  CAS  Google Scholar 

  29. Shappley 3rd WV, Kenfield SA, Kasperzyk JL, et al. Prospective study of determinants and outcomes of deferred treatment or watchful waiting among men with prostate cancer in a nationwide cohort. J Clin Oncol. 2009 Oct 20;27(30):4980–5.

    Article  PubMed  Google Scholar 

  30. Epstein JI, Pizov G, Walsh PC. Correlation of ­pathologic findings with progression after radical ­retropubic prostatectomy. Cancer. 1993 Jun 1;71(11):3582–93.

    Article  PubMed  CAS  Google Scholar 

  31. Epstein JI, Carmichael M, Partin AW, Walsh PC. Is tumor volume an independent predictor of progression following radical prostatectomy? A multivariate analysis of 185 clinical stage B adenocarcinomas of the prostate with 5 years of followup. J Urol. 1993 Jun;149(6):1478–81.

    PubMed  CAS  Google Scholar 

  32. Epstein JI, Walsh PC, Carmichael M, Brendler CB. Pathologic and clinical findings to predict tumor extent of nonpalpable (stage T1c) prostate cancer. JAMA. 1994 Feb 2;271(5):368–74.

    Article  PubMed  CAS  Google Scholar 

  33. Carter HB, Sauvageot J, Walsh PC, Epstein JI. Prospective evaluation of men with stage T1C adenocarcinoma of the prostate. J Urol. 1997 Jun;157(6):2206–9.

    Article  PubMed  CAS  Google Scholar 

  34. Bastian PJ, Mangold LA, Epstein JI, Partin AW. Characteristics of insignificant clinical T1c prostate tumors. A contemporary analysis. Cancer. 2004 Nov 1;101(9):2001–5.

    Article  PubMed  Google Scholar 

  35. Lee MC, Dong F, Stephenson AJ, Jones JS, Magi-Galluzzi C, Klein EA. The Epstein criteria predict for organ-confined but not insignificant disease and a high likelihood of cure at radical prostatectomy. Eur Urol. 2010 Jul;58(1):90–5.

    Article  PubMed  Google Scholar 

  36. Makarov DV, Trock BJ, Humphreys EB, et al. Updated nomogram to predict pathologic stage of prostate cancer given prostate-specific antigen level, clinical stage, and biopsy Gleason score (Partin tables) based on cases from 2000 to 2005. Urology. 2007 Jun;69(6):1095–101.

    Article  PubMed  Google Scholar 

  37. D’Amico AV, Moul J, Carroll PR, Sun L, Lubeck D, Chen MH. Cancer-specific mortality after surgery or radiation for patients with clinically localized prostate cancer managed during the prostate-specific antigen era. J Clin Oncol. 2003 Jun 1;21(11):2163–72.

    Article  PubMed  Google Scholar 

  38. Kattan MW, Eastham JA, Wheeler TM, et al. Counseling men with prostate cancer: a nomogram for predicting the presence of small, moderately differentiated, confined tumors. J Urol. 2003 Nov;170(5):1792–7.

    Article  PubMed  Google Scholar 

  39. Chun FK, Haese A, Ahyai SA, et al. Critical assessment of tools to predict clinically insignificant prostate cancer at radical prostatectomy in contemporary men. Cancer. 2008 Aug 15;113(4):701–9.

    Article  PubMed  Google Scholar 

  40. Roemeling S, Roobol MJ, Kattan MW, van der Kwast TH, Steyerberg EW, Schroder FH. Nomogram use for the prediction of indolent prostate cancer: impact on screen-detected populations. Cancer. 2007 Nov 15;110(10):2218–21.

    Article  PubMed  Google Scholar 

  41. Cooperberg MR, Broering JM, Carroll PR. Risk assessment for prostate cancer metastasis and mortality at the time of diagnosis. J Natl Cancer Inst. 2009 Jun 16;101(12):878–87.

    Article  PubMed  Google Scholar 

  42. Klotz L, Zhang L, Lam A, Nam R, Mamedov A, Loblaw A. Clinical results of long-term follow-up of a large, active surveillance cohort with localized prostate cancer. J Clin Oncol. 2010 Jan 1;28(1):126–31.

    Article  PubMed  Google Scholar 

  43. van den Bergh RC, Steyerberg EW, Khatami A, et al. Is delayed radical prostatectomy in men with low-risk screen-detected prostate cancer associated with a higher risk of unfavorable outcomes? Cancer. 2010 Mar 1;116(5):1281–90.

    Article  PubMed  Google Scholar 

  44. van As NJ, Norman AR, Thomas K, et al. Predicting the probability of deferred radical treatment for localised prostate cancer managed by active surveillance. Eur Urol. 2008 Dec;54(6):1297–305.

    Article  PubMed  Google Scholar 

  45. Soloway MS, Soloway CT, Williams S, Ayyathurai R, Kava B, Manoharan M. Active surveillance; a reasonable management alternative for patients with prostate cancer: the Miami experience. BJU Int. 2008 Jan;101(2):165–9.

    PubMed  Google Scholar 

  46. Tosoian JJ, Trock BJ, Landis P, et al. Active surveillance program for prostate cancer: an update of the Johns Hopkins experience. J Clin Oncol. 2011 Jun 1;29(16):2185–90.

    Article  PubMed  Google Scholar 

  47. Tseng KS, Landis P, Epstein JI, Trock BJ, Carter HB. Risk stratification of men choosing surveillance for low risk prostate cancer. J Urol. 2010 May;183(5):1779–85.

    Article  PubMed  CAS  Google Scholar 

  48. Dall’Era MA, Konety BR, Cowan JE, et al. Active surveillance for the management of prostate cancer in a contemporary cohort. Cancer. 2008 Jun 15;112(12): 2664–70.

    Article  PubMed  Google Scholar 

  49. San Francisco IF, Werner L, Regan MM, Garnick MB, Bubley G, DeWolf WC. Risk stratification and validation of prostate specific antigen density as independent predictor of progression in men with low risk prostate cancer during active surveillance. J Urol. 2011 Feb;185(2):471–6.

    Article  PubMed  Google Scholar 

  50. Warlick C, Trock BJ, Landis P, Epstein JI, Carter HB. Delayed versus immediate surgical intervention and prostate cancer outcome. J Natl Cancer Inst. 2006 Mar 1;98(5):355–7.

    Article  PubMed  Google Scholar 

  51. Kane CJ, Im R, Amling CL, et al. Outcomes after radical prostatectomy among men who are candidates for active surveillance: results from the SEARCH database. Urology. 2010 Sep;76(3):695–700.

    Article  PubMed  Google Scholar 

  52. Widmark A, Klepp O, Solberg A, et al. Endocrine treatment, with or without radiotherapy, in locally advanced prostate cancer (SPCG-7/SFUO-3): an open randomised phase III trial. Lancet. 2009 Jan 24;373(9660):301–8.

    Article  PubMed  CAS  Google Scholar 

  53. Bill-Axelson A, Holmberg L, Ruutu M, et al. Radical prostatectomy versus watchful waiting in early prostate cancer. N Engl J Med. 2011 May 5;364(18):1708–17.

    Article  PubMed  CAS  Google Scholar 

  54. van den Bergh RC, Roemeling S, Roobol MJ, et al. Outcomes of men with screen-detected prostate cancer eligible for active surveillance who were managed expectantly. Eur Urol. 2009 Jan;55(1):1–8.

    Article  PubMed  Google Scholar 

  55. Eggener SE, Mueller A, Berglund RK, et al. A multi-institutional evaluation of active surveillance for low risk prostate cancer. J Urol. 2009 Apr;181(4):1635–41; discussion 41.

    Article  PubMed  Google Scholar 

  56. van den Bergh RC, Roemeling S, Roobol MJ, et al. Gleason score 7 screen-detected prostate cancers initially managed expectantly: outcomes in 50 men. BJU Int. 2009 Jun;103(11):1472–7.

    Article  PubMed  Google Scholar 

  57. Krakowsky Y, Loblaw A, Klotz L. Prostate cancer death of men treated with initial active surveillance: clinical and biochemical characteristics. J Urol. 2010 Jul;184(1):131–5.

    Article  PubMed  Google Scholar 

  58. Suardi N, Briganti A, Gallina A, et al. Testing the most stringent criteria for selection of candidates for active surveillance in patients with low-risk prostate cancer. BJU Int. 2010 Jun;105(11):1548–52.

    Article  PubMed  Google Scholar 

  59. Conti SL, Dall’era M, Fradet V, Cowan JE, Simko J, Carroll PR. Pathological outcomes of candidates for active surveillance of prostate cancer. J Urol. 2009 Apr;181(4):1628–33; discussion 33–4.

    Article  PubMed  Google Scholar 

  60. Suardi N, Capitanio U, Chun FK, et al. Currently used criteria for active surveillance in men with low-risk prostate cancer: an analysis of pathologic features. Cancer. 2008 Oct 15;113(8):2068–72.

    Article  PubMed  Google Scholar 

  61. Magheli A, Hinz S, Hege C, et al. Prostate specific antigen density to predict prostate cancer upgrading in a contemporary radical prostatectomy series: a single center experience. J Urol. 2010 Jan;183(1):126–31.

    Article  PubMed  Google Scholar 

  62. Kulkarni GS, Lockwood G, Evans A, et al. Clinical predictors of Gleason score upgrading: implications for patients considering watchful waiting, active surveillance, or brachytherapy. Cancer. 2007 Jun 15;109(12):2432–8.

    Article  PubMed  Google Scholar 

  63. Khatami A, Aus G, Damber JE, Lilja H, Lodding P, Hugosson J. PSA doubling time predicts the outcome after active surveillance in screening-detected prostate cancer: results from the European randomized study of screening for prostate cancer, Sweden section. Int J Cancer. 2007 Jan 1;120(1):170–4.

    Article  PubMed  Google Scholar 

  64. Ross AE, Loeb S, Landis P, et al. Prostate-specific antigen kinetics during follow-up are an unreliable trigger for intervention in a prostate cancer surveillance program. J Clin Oncol. 2010 Jun 10;28(17):2810–16.

    Article  PubMed  CAS  Google Scholar 

  65. Ploussard G, Xylinas E, Salomon L, et al. The role of biopsy core number in selecting prostate cancer patients for active surveillance. Eur Urol. 2009 Dec;56(6):891–8.

    Article  PubMed  Google Scholar 

  66. Chun FK, Epstein JI, Ficarra V, et al. Optimizing performance and interpretation of prostate biopsy: a critical analysis of the literature. Eur Urol. Sept 4.

    Google Scholar 

  67. Duffield AS, Lee TK, Miyamoto H, Carter HB, Epstein JI. Radical prostatectomy findings in patients in whom active surveillance of prostate cancer fails. J Urol. 2009 Nov;182(5):2274–8.

    Article  PubMed  Google Scholar 

  68. Miocinovic R, Jones JS, Pujara AC, Klein EA, Stephenson AJ. Acceptance and durability of surveillance as a management choice in men with screen-detected, low-risk prostate cancer: improved outcomes with stringent enrollment criteria. Urology. Jan 20.

    Google Scholar 

  69. Berglund RK, Masterson TA, Vora KC, Eggener SE, Eastham JA, Guillonneau BD. Pathological upgrading and up staging with immediate repeat biopsy in patients eligible for active surveillance. J Urol. 2008 Nov;180(5):1964–7; discussion 7–8.

    Article  PubMed  Google Scholar 

  70. Barocas DA, Cowan JE, Smith Jr JA, Carroll PR. What percentage of patients with newly diagnosed carcinoma of the prostate are candidates for surveillance? An analysis of the CaPSURE database. J Urol. 2008 Oct;180(4):1330–4; discussion 4–5.

    Article  PubMed  Google Scholar 

  71. Han M, Partin AW, Zahurak M, Piantadosi S, Epstein JI, Walsh PC. Biochemical (prostate specific antigen) recurrence probability following radical prostatectomy for clinically localized prostate cancer. J Urol. 2003 Feb;169(2):517–23.

    Article  PubMed  Google Scholar 

  72. Albertsen PC, Fryback DG, Storer BE, Kolon TF, Fine J. The impact of co-morbidity on life expectancy among men with localized prostate cancer. J Urol. 1996 Jul;156(1):127–32.

    Article  PubMed  CAS  Google Scholar 

  73. Cowen ME, Halasyamani LK, Kattan MW. Predicting life expectancy in men with clinically localized prostate cancer. J Urol. 2006 Jan;175(1):99–103.

    Article  PubMed  Google Scholar 

  74. Jeldres C, Latouff JB, Saad F. Predicting life expectancy in prostate cancer patients. Curr Opin Support Palliat Care. 2009 Sep;3(3):166–9.

    Article  PubMed  Google Scholar 

  75. Howard DH. Life expectancy and the value of early detection. J Health Econ. 2005 Sep;24(5):891–906.

    Article  PubMed  Google Scholar 

  76. Period Life Table, 2006. 2010 [cited; Available from: http://www.ssa.gov/OACT/STATS/table4c6.html].

  77. Clayton DB, Urban DA. Point: the value of predicting life expectancy in men with clinically localized prostate cancer. J Natl Compr Canc Netw. 2007 Aug;5(7):703–8.

    PubMed  Google Scholar 

  78. Steineck G, Helgesen F, Adolfsson J, et al. Quality of life after radical prostatectomy or watchful waiting. N Engl J Med. 2002 Sep 12;347(11):790–6.

    Article  PubMed  Google Scholar 

  79. Litwin MS, Lubeck DP, Spitalny GM, Henning JM, Carroll PR. Mental health in men treated for early stage prostate carcinoma: a posttreatment, longitudinal quality of life analysis from the Cancer of the Prostate Strategic Urologic Research Endeavor. Cancer. 2002 Jul 1;95(1):54–60.

    Article  PubMed  Google Scholar 

  80. Johansson E, Bill-Axelson A, Holmberg L, Onelov E, Johansson JE, Steineck G. Time, symptom burden, androgen deprivation, and self-assessed quality of life after radical prostatectomy or watchful waiting: the Randomized Scandinavian Prostate Cancer Group Study Number 4 (SPCG-4) clinical trial. Eur Urol. 2009 Feb;55(2):422–30.

    Article  PubMed  Google Scholar 

  81. van den Bergh RC, Essink-Bot ML, Roobol MJ, et al. Anxiety and distress during active surveillance for early prostate cancer. Cancer. 2009 Sep 1;115(17):3868–78.

    Article  PubMed  Google Scholar 

  82. Latini DM, Hart SL, Knight SJ, et al. The relationship between anxiety and time to treatment for patients with prostate cancer on surveillance. J Urol. 2007 Sep;178(3 Pt 1):826–31; discussion 31–2.

    Article  PubMed  Google Scholar 

  83. Sanda MG, Dunn RL, Michalski J, et al. Quality of life and satisfaction with outcome among prostate-cancer survivors. N Engl J Med. 2008 Mar 20;358(12):1250–61.

    Article  PubMed  CAS  Google Scholar 

  84. Liu D, Lehmann HP, Frick KD, Carter HB. Active surveillance vs surgery in low-risk prostate cancer: a clinical decision analysis. J Urol. 2012 Apr;187(4):1241–6.

    Article  PubMed  Google Scholar 

  85. Hayes JH, Ollendorf DA, Pearson SD, et al. Active surveillance compared with initial treatment for men with low-risk prostate cancer: a decision analysis. JAMA. 2010 Dec 1;304(21):2373–80.

    Article  PubMed  CAS  Google Scholar 

  86. Bailey DE, Mishel MH, Belyea M, Stewart JL, Mohler J. Uncertainty intervention for watchful waiting in prostate cancer. Cancer Nurs. 2004 Sep–Oct;27(5):339–46.

    Article  PubMed  Google Scholar 

  87. Kronenwetter C, Weidner G, Pettengill E, et al. A qualitative analysis of interviews of men with early stage prostate cancer: the Prostate Cancer Lifestyle Trial. Cancer Nurs. 2005 Mar–Apr;28(2):99–107.

    Article  PubMed  Google Scholar 

  88. Warlick CA. Editorial comment. J Urol. 2007 Sep;178(3):831–2.

    Article  Google Scholar 

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Authors and Affiliations

  1. The James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutes, Marburg 145. 600 N. Wolfe St., Baltimore, MD, USA

    John B. Eifler M.D. & H. Ballentine Carter M.D.

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  1. John B. Eifler M.D.
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Correspondence to H. Ballentine Carter M.D. .

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  1. University of Toronto, Sunnybrook Health Sciences Centre, Division of Urology, Toronto, M4N 3M5, Ontario, Canada

    Laurence Klotz

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Eifler, J.B., Carter, H.B. (2012). Patient Selection for Active Surveillance. In: Klotz, L. (eds) Active Surveillance for Localized Prostate Cancer. Current Clinical Urology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-61779-912-9_2

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