improvement, treatment may be extended for up to 5 additional days (i.e., up to a total of 10 days).

criteria. The role of PHI, Progensa PCA3, and SelectMDX in deciding whether to take a repeat biopsy in men who had a previous negative biopsy is uncertain and probably not cost-effective [Table 5.2.5.1: Description of additional investigational tests after a negative prostate biopsy**Isolated high-grade prostatic intraepithelial neoplasia (PIN) in one or two biopsy sites is no longer an indicationThe incidence of PCa detected by saturation repeat biopsy (> 20 cores) is 30-43% and depends on the number of cores sampled during earlier biopsies [On baseline biopsies, where no prior imaging with mpMRI has been performed, or where mpMRI has not shown any suspicious lesion, the sample sites should be bilateral from apex to base, as far posterior and lateral as possible in the peripheral gland. For example, anterior suspension is performed either through periosteum of the pubis or the combination of ligated DVC and puboprostatic ligaments (PPL). Synoptic reporting results in more transparent and complete pathology reporting [Table 5.2.7.1: Mandatory elements provided by the pathology reportHistopathological type: > 95% of PCa represents conventional (acinar) adenocarcinoma.Grading according to ISUP grade (or not applicable if therapy-related changes).Tumour (sub)staging and surgical margin status: location and extent of EPE, presence of bladder neck invasion, laterality of EPE or seminal vesicle invasion, location and extent of positive surgical margins.Additional information may be provided on multifocality, and diameter/volume and zonal location of the dominant tumour.Table 5.2.7.2: Example checklist: reporting of prostatectomy specimensType of carcinoma, e.g. and should be treated for existing conditions, such as diabetes, hyperlipidaemia, and/or hypertension [After the initiation of ADT, it is recommended that patients are followed at 3 to 6 month intervals. A recent phase III RCT comparing adjuvant docetaxel against surveillance after RP for locally advanced PCa showed that adjuvant docetaxel did not confer any oncological benefit [Do not prescribe adjuvant androgen deprivation therapy (ADT) in pN0 patients.Offer adjuvant external-beam radiation therapy to the surgical field to highly selected patients.Discuss three management options with patients with pN+ disease after an extended lymph node dissection, based on nodal involvement characteristics:2.

In summary, there was conflicting evidence regarding the benefit of RP over deferred treatment. Most of the data were generated by one high-volume centre.

Changes in recommendations were only considered on the basis of high level evidence (i.e. Therefore, if you wish to sell the CDC materials presented on CDC’s website, you must first obtain permission to do so from CDC.Centers for Disease Control and Prevention. delayed adaptation to darkness), alcohol intolerance, nausea, and of note, severe interstitial pneumonitis (potentially life-threatening). Abrams P, Cardozo L, Khoury S, Wein A. The first (8.2) will summarise long-term consequences (Quality of life and personalised care go hand in hand. A systematic review and meta-analysis on the impact of BCR after RP reports SRT to be favourable for OS and PCa-specific mortality. In addition, approximately 40% of randomised patients had intermediate-risk disease.Nevertheless, in spite of these caveats, the ProtecT study has reinforced the role of deferred active treatment (i.e. Two men had late grade 3 reactions of the GI tract. pT2/pT3 with positive surgical margins and GS 8-10) post-RP (Table 6.2.5.1).

2010;50:625-663. Publications ensuing from systematic reviews have all been peer-reviewed.Results of ongoing and new SRs will be included in the 2021 update of the PCa Guidelines:Prostate cancer is the second most commonly diagnosed cancer in men, with an estimated 1.1 million diagnoses worldwide in 2012, accounting for 15% of all cancers diagnosed [The incidence of PCa diagnosis varies widely between different geographical areas, being highest in Australia/New Zealand and Northern America (age-standardised rates [ASR] per 100,000 of 111.6 and 97.2, respectively), and in Western and Northern Europe (ASRs of 94.9 and 85, respectively), largely due to the use of prostate-specific antigen (PSA) testing and the aging population. Again the majority of patients treated had Table 6.4.4: Results from the STAMPEDE arm G and LATITUDE studies- locally advanced (at least two of cT3 cT4, ISUP grade - relapsing locally treated disease with a PSA > 4 ng/mL and a PSA-DT < 6 mo.Newly diagnosed M1 disease and 2 out of the 3 risk factors: ISUP grade Failure-free survival (biological, radiological, clinical or death):AA = abiraterone acetate; ADT = androgen deprivation therapy; CI = confidence interval; ECOG = Eastern Cooperative Oncology Group; HR = hazard ratio; mo = month; n = number of patients; NA = not available; OS = overall survival; P = prednisone; PFS = progression-free survival; PSA = prostate-specific antigen; yr. = year.Table 6.4.5 Results from the ENZAMET and TITAN studiesADT = androgen deprivation therapy; CI = confidence interval; HR = hazard ratio; mo = month; n = number of patients; NA = not available; OS = overall survival; SOC = standard of care; PFS = progression-free survival; yr = year.There are no head-to-head data comparing 6 cycles of docetaxel and the long-term use of abiraterone acetate plus prednisone in newly diagnosed mHSPC. In the SPCG-4 study, death from any cause (RR: 0.71; 95% CI: 0.53-0.95), death from PCa (RR: 0.38; 95% CI: 0.23-0.62) and distant metastases (RR: 0.49; 95% CI: 0.32-0.74) were significantly reduced in intermediate-risk PCa at 18 years. uncomplicated patients with UI and are more useable in daily practice. Several small RCTs have been conducted, however pooling analyses is hampered by variation in the definitions of incontinence, and surgical approach, such as open vs. robotic and intraperitoneal vs. extraperitoneal.