ArticleEuropean urology2017
Active Surveillance Versus Watchful Waiting for Localized Prostate Cancer: A Model to Inform Decisions.
Article in European urology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 32 citations in OpenAlex.
- Incorporating Magnetic Resonance Imaging and Biomarkers in Active Surveillance Protocols - Results From the Prospective Stockholm3 Active Surveillance Trial (STHLM3AS).Journal of the National Cancer Institute · 2021Trial
- Population-Level Resources and Costs Associated with Low-Risk Prostate Cancer Patients on Active Surveillance.Cancers · 2026Article
- When coverage is not enough: the case for strengthening uro-oncology Worldwide.International journal of surgery (London, England) · 2026Article
- Intertemporal Decision-Making Ability in Patients with Chronic Diseases: A Concept Analysis.Patient preference and adherence · 2026Review
- Treatment variations in localised prostate cancer in Australia and New Zealand: a registry study.BJU international · 2025Article
- Patient Reported Outcomes and Treatment-Associated Complications as a Consideration in Selecting Localized Prostate Cancer Management.Research and reports in urology · 2025Review
- Estimating Joint Health State Utility Algorithms Under Partial Information.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2023Article
- Validation of an MRI-based prostate cancer prebiopsy Gleason score predictive nomogram.Current urology · 2022Article
- Prostate Cancer Disparities and Management in Southern Africa: Insights into Practices, Norms and Values.Cancer management and research · 2022Review
- Article
- Active Surveillance Strategies for Low-Grade Prostate Cancer: Comparative Benefits and Cost-effectiveness.Radiology · 2021Article
- When and How Should Active Surveillance for Prostate Cancer be De-Escalated?European urology focus · 2021Review
- Evidence-based approach to active surveillance of prostate cancer.World journal of urology · 2020Review
- Article
- Review
- Health utility and health-related quality of life of Japanese prostate cancer patients according to progression status measured using EQ-5D-5L and FACT-P.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2019Article
- The mapping of cancer incidence and mortality trends in the UK from 1980-2013 reveals a potential for overdiagnosis.Scientific reports · 2018Article
- Active surveillance: a review of risk-based, dynamic monitoring.Translational andrology and urology · 2018Review
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Authors and funding
9 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundAn increasing proportion of prostate cancer is being managed conservatively. However, there are no randomized trials or consensus regarding the optimal follow-up strategy.
objectiveTo compare life expectancy and quality of life between watchful waiting (WW) versus different strategies of active surveillance (AS). DESIGN, SETTING, AND
participantsA Markov model was created for US men starting at age 50, diagnosed with localized prostate cancer who chose conservative management by WW or AS using different testing protocols (prostate-specific antigen every 3-6 mo, biopsy every 1-5 yr, or magnetic resonance imaging based). Transition probabilities and utilities were obtained from the literature. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Primary outcomes were life years and quality-adjusted life years (QALYs). Secondary outcomes include radical treatment, metastasis, and prostate cancer death. RESULTS AND LIMITATIONS: All AS strategies yielded more life years compared with WW. Lifetime risks of prostate cancer death and metastasis were, respectively, 5.42% and 6.40% with AS versus 8.72% and 10.30% with WW. AS yielded more QALYs than WW except in cohorts age >65 yr at diagnosis, or when treatment-related complications were long term. The preferred follow-up strategy was also sensitive to whether people value short-term over long-term benefits (time preference). Depending on the AS protocol, 30-41% underwent radical treatment within 10 yr. Extending the surveillance biopsy interval from 1 to 5 yr reduced life years slightly, with a 0.26 difference in QALYs.
conclusionsAS extends life more than WW, particularly for men with higher-risk features, but this is partly offset by the decrement in quality of life since many men eventually receive treatment. PATIENT SUMMARY: More intensive active surveillance protocols extend life more than watchful waiting, but this is partly offset by decrements in quality of life from subsequent treatment.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.