Active surveillance represents a viable option in men with low-risk PCa and a long life expectancy .
A biopsy progression indicates the need for active intervention , whereas the role of PSA doubling time is controversial .
In men with locally advanced PCa for whom local therapy is not m and atory , watchful waiting ( WW ) is a treatment alternative to and rogen-deprivation therapy ( ADT ) , with equivalent oncologic efficacy .
Active treatment is recommended mostly for patients with localized disease and a long life expectancy , with radical prostatectomy ( RP ) shown to be superior to WW in prospect i ve r and omized trials .
Nerve-sparing RP is the approach of choice in organ-confined disease , while neoadjuvant ADT provides no improvement in outcome variables .
For locally advanced disease , adjuvant ADT for 3 yr results in superior rates for disease-specific and overall survival and is the treatment of choice .
Active surveillance is an option in low-risk PCa and watchful waiting is an alternative to and rogen-deprivation therapy in locally advanced PCa not requiring immediate local treatment .
CONTEXT The most recent summary of the European Association of Urology ( EAU ) guidelines on prostate cancer ( PCa ) was published in 2011 .
OBJECTIVE To present a summary of the 2013 version of the EAU guidelines on screening , diagnosis , and local treatment with curative intent of clinical ly organ-confined PCa .
Current evidence is insufficient to warrant widespread population -based screening by prostate-specific antigen ( PSA ) for PCa .
Systematic prostate biopsies under ultrasound guidance and local anesthesia are the preferred diagnostic method .
CONCLUSIONS Knowledge in the field of PCa is rapidly changing .
Lack of benefit for the addition of androgen deprivation therapy to dose-escalated radiotherapy in the treatment of intermediate- and high-risk prostate cancer.
PURPOSE Assessment of and rogen deprivation therapy ( ADT ) benefits for prostate cancer treated with dose-escalated radiotherapy ( RT ) . METHODS AND MATERIAL S From 1991 to 2004 , 1,044 patients with intermediate- ( n = 782 ) or high-risk ( n = 262 ) prostate cancer were treated with dose-escalated RT at William Beaumont Hospital . Patients received external-beam RT ( EBRT ) alone , brachytherapy ( high or low dose rate ) , or high dose rate brachytherapy plus pelvic EBRT .  Intermediate-risk patients had Gleason score 7 , prostate-specific antigen ( PSA ) 10.0 - 19.9 ng/mL , or Stage T2b-T2c . High-risk patients had Gleason score 8 - 10 , PSA ≥20 , or Stage T3 . Patients were additionally divided specifically by Gleason score , presence of palpable disease , and PSA level to further define subgroups benefitting from ADT . RESULTS Median follow-up was 5 years ; 420 patients received ADT + dose-escalated RT , and 624 received dose-escalated RT alone . For all patients , no advantages in any clinical endpoints at 8 years were associated with ADT administration . No differences in any endpoints were associated with ADT administration based on intermediate- vs. high-risk group or RT modality when analyzed separately . Patients with palpable disease plus Gleason ≥8 demonstrated improved clinical failure rates and a trend toward improved survival with ADT . Intermediate-risk patients treated with brachytherapy alone had improved biochemical control when ADT was given . CONCLUSION Benefits of ADT in the setting of dose-escalated RT remain poorly defined . This question must continue to be addressed in prospect i ve study
Active surveillance represents a viable option in men with low-risk PCa and a long life expectancy .
A biopsy progression indicates the need for active intervention , whereas the role of PSA doubling time is controversial .
In men with locally advanced PCa for whom local therapy is not m and atory , watchful waiting ( WW ) is a treatment alternative to and rogen-deprivation therapy ( ADT ) , with equivalent oncologic efficacy .
Active treatment is recommended mostly for patients with localized disease and a long life expectancy , with radical prostatectomy ( RP ) shown to be superior to WW in prospect i ve r and omized trials .
Nerve-sparing RP is the approach of choice in organ-confined disease , while neoadjuvant ADT provides no improvement in outcome variables .
For locally advanced disease , adjuvant ADT for 3 yr results in superior rates for disease-specific and overall survival and is the treatment of choice .
Active surveillance is an option in low-risk PCa and watchful waiting is an alternative to and rogen-deprivation therapy in locally advanced PCa not requiring immediate local treatment .
CONTEXT The most recent summary of the European Association of Urology ( EAU ) guidelines on prostate cancer ( PCa ) was published in 2011 .
OBJECTIVE To present a summary of the 2013 version of the EAU guidelines on screening , diagnosis , and local treatment with curative intent of clinical ly organ-confined PCa .
Current evidence is insufficient to warrant widespread population -based screening by prostate-specific antigen ( PSA ) for PCa .
Systematic prostate biopsies under ultrasound guidance and local anesthesia are the preferred diagnostic method .
CONCLUSIONS Knowledge in the field of PCa is rapidly changing .