GuidelinesEAU Guidelines on Prostate Cancer. Part II: Treatment of Advanced, Relapsing, and Castration-Resistant Prostate Cancer
Introduction
The most recent summary of the European Association of Urology (EAU) guidelines on prostate cancer (PCa) was published in 2011 [1]. This paper summarises the 2013 update of the EAU guidelines on the treatment of advanced, relapsing, and castration-resistant PCa (CRPC). The guidelines on screening, diagnosis, and treatment of clinically localised PCa were published in a separate paper. To facilitate evaluating the quality of the information provided, evidence levels and grade of recommendation have been inserted according to the general principles of evidence-based medicine [2].
Section snippets
Luteinising hormone-releasing hormone: analogues and antagonists
Luteinising hormone-releasing hormone (LHRH) agonists have become the standard of care in hormonal therapy because these agents have the potential of reversibility and enable the use of intermittent androgen-deprivation therapy (ADT), avoid the physical and psychological discomfort associated with orchiectomy, have a lower risk of cardiotoxicity than observed with diethylstilbestrol, and result in equivalent oncologic efficacy [3], [4].
In contrast to the agonists, LHRH antagonists result in a
Definition of recurrence
Following RP, a confirmed PSA value >0.2 ng/ml (ie, two consecutive increases) represents recurrent cancer [36]. Following RT, a PSA value of 2 ng/ml above the nadir after RT represents recurrent cancer (Phoenix classification [37]).
Local failure following RP might be predicted with an 80% probability by a PSA increase >3 yr after RP, a PSA DT >11 mo, a Gleason score <7, and stage ≤pT3a pN0, pTx R1. Systemic failure following RP might be predicted with >80% accuracy by a PSA increase <1 yr
Summary
The present text represents a summary. For more detailed information and a full list of references, refer to the full-text version. These EAU guidelines (ISBN 978-90-79754-71-7) are available at the EAU Web site: http://www.uroweb.org/guidelines/online-guidelines/.
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Cited by (0)
- 1
Chair of the EAU Prostate Cancer Guidelines Group, 2008 to March 2013.
- 2
Chair of the EAU Prostate Cancer Guidelines Group since March 2013.