Place de la surveillance active dans le cancer de la prostate : présentation du protocole français

The 10 years survival of screen detected prostate cancer in higher than 70 % when the Gleason is < 7, leading to the question of insignificant forms. They are characterized by a very slow growth, postponing an active treatment for years. They require an active surveillance not to miss the window of curability. The initial characterization in not accurate, and is based on at least the following: T1c, PSA < 10 ng/ml, Gleason < 7, few positive cores with a short length of cancer. They could represent up to 40 % of screen detected lesions. The initial results are encouraging, with more than 99 % specific survival at 8 years, without any treatment at 5 years in 70 % of patients. Their inaccurate definition justifies a prospective national trial based on strict criteria. Its main question is the 10 years specific survival.