Moderate hypofractionation is safe and effective , but longer-term data are still lacking .
Brachytherapy represents an effective way to increase the delivered dose .
OBJECTIVE To present a summary of the 2016 version of the European Association of Urology ( EAU ) - European Society for Radiotherapy & Oncology ( ESTRO ) - International Society of Geriatric Oncology ( SIOG ) Guidelines on screening , diagnosis , and local treatment with curative intent of clinical ly localised prostate cancer ( PCa ) .
EVIDENCE SYNTHESIS BRCA2 mutations have been added as risk factors for early and aggressive disease .
Systematic screening is still not recommended .
An early prostate-specific antigen test , the use of a risk calculator , or one of the promising biomarker tools are being investigated and might be able to limit the overdetection of insignificant PCa .
Breaking the link between diagnosis and treatment may lower the overtreatment risk .
Multiparametric magnetic resonance imaging using st and ardised reporting can not replace systematic biopsy , but robustly nested within the diagnostic work-up , it has a key role in local staging .
In Northern and Western Europe , the number of men diagnosed with PCa has been on the rise .
Long-term failure patterns and survival in a randomized dose-escalation trial for prostate cancer. Who dies of disease?
PURPOSE To report long-term failure patterns and survival in a r and omized radiotherapy dose escalation trial for prostate cancer . MATERIAL S AND METHODS A total of 301 patients with Stage T1b-T3 prostate cancer treated to 70 Gy versus 78 Gy now have a median follow-up of 9 years .  Failure patterns and survival were compared between dose levels . The cumulative incidence of death from prostate cancer versus other causes was examined and regression analysis was used to establish predictive factors . RESULTS Patients with pretreatment prostate-specific antigen ( PSA ) > 10 ng/mL or high-risk disease had higher biochemical and clinical failures rates when treated to 70 Gy . These patients also had a significantly higher risk of dying of prostate cancer .  Patients < 70 years old at treatment died of prostate cancer nearly three times more frequently than of other causes when they were radiated to 70 Gy , whereas those treated to 78 Gy died of other causes more frequently . Patients age 70 or older treated to 70 Gy died of prostate cancer as often as other causes , and those receiving 78 Gy never died of prostate cancer within 10 years of follow-up . In regression analysis , factors predicting for death from prostate cancer were pretreatment PSA > 10.5 ng/mL , Gleason score 9 and 10 , recurrence within 2.6 years of radiation , and doubling time of < 3.6 months at the time of recurrence . CONCLUSIONS Moderate dose escalation ( 78 Gy ) decreases biochemical and clinical failure as well as prostate cancer death in patients with pretreatment PSA > 10 ng/mL or high-risk disease
Moderate hypofractionation is safe and effective , but longer-term data are still lacking .
Brachytherapy represents an effective way to increase the delivered dose .
OBJECTIVE To present a summary of the 2016 version of the European Association of Urology ( EAU ) - European Society for Radiotherapy & Oncology ( ESTRO ) - International Society of Geriatric Oncology ( SIOG ) Guidelines on screening , diagnosis , and local treatment with curative intent of clinical ly localised prostate cancer ( PCa ) .
EVIDENCE SYNTHESIS BRCA2 mutations have been added as risk factors for early and aggressive disease .
Systematic screening is still not recommended .
An early prostate-specific antigen test , the use of a risk calculator , or one of the promising biomarker tools are being investigated and might be able to limit the overdetection of insignificant PCa .
Breaking the link between diagnosis and treatment may lower the overtreatment risk .
Multiparametric magnetic resonance imaging using st and ardised reporting can not replace systematic biopsy , but robustly nested within the diagnostic work-up , it has a key role in local staging .
In Northern and Western Europe , the number of men diagnosed with PCa has been on the rise .