Active surveillance represents a viable option in men with low-risk PCa and a long life expectancy .
PSA doubling time in <3 yr or a biopsy progression indicates the need for active intervention .
In men with locally advanced PCa in 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 mostly recommended for patients with localised disease and a long life expectancy with radical prostatectomy ( RP ) shown to be superior to WW in a prospect i ve r and omised trial .
Nerve-sparing RP represents the approach of choice in organ-confined disease ; neoadjuvant and rogen deprivation demonstrates no improvement of outcome variables .
For locally advanced disease , adjuvant ADT for 3 yr results in superior disease-specific and overall survival rates and represents the treatment of choice .
OBJECTIVE Our aim was to present a summary of the 2010 version of the European Association of Urology ( EAU ) guidelines on the screening , diagnosis , and treatment of clinical ly localised cancer of the prostate ( PCa ) .
Current evidence is insufficient to warrant widespread population -based screening by prostate-specific antigen ( PSA ) for PCa .
A systematic prostate biopsy under ultrasound guidance and local anaesthesia is the preferred diagnostic method .
Intermediate-term potency, continence, and survival outcomes of radical prostatectomy for clinically high-risk or locally advanced prostate cancer.
OBJECTIVES Controversy exists about the preferred treatment of patients with high-risk or locally advanced prostate cancer . We examined the intermediate-term cancer control and quality -of-life outcomes after  radical retropubic prostatectomy ( RRP ) in selected patients . METHODS From 1984 to 2003 , 288 men with Stage cT2b ( Gleason score 8 to 10 or a prostate-specific antigen level greater than 15 ng/mL ) or T3 disease underwent RRP by a single surgeon . The 7 and 10-year actuarial progression-free survival ( PFS ) , cancer-specific survival ( CSS ) , overall survival ( OS ) , potency , and continence rates were recorded . RESULTS The actuarial 7-year PFS , CSS , and OS rate after surgery was 39 % , 92 % , and 91 % , respectively . The corresponding actuarial 10-year rates were 35 % , 88 % , and 74 % . Only OS differed significantly by age group . On multivariate analysis , the pathologic stage was a significant independent predictor of progression . Ultimately , 31 men ( 11 % ) required hormonal therapy , 58 ( 20 % ) underwent postoperative radiotherapy , and 67 ( 23 % ) received both . Potency and continence were preserved in 64 % and 92 % , respectively . CONCLUSIONS Overall , RRP offers excellent intermediate-term cancer control for selected men of all ages who present with high-risk or locally advanced disease . The PFS was significantly greater for men with high-risk Stage cT2b than for those with cT3 disease , but the CSS and OS were similar . Both continence and potency were preserved in most patients , although the potency rates were significantly greater for the younger men . RRP with appropriate postoperative radiotherapy and /or hormonal therapy is a reasonable treatment option for selected men with high-risk or locally advanced disease
Active surveillance represents a viable option in men with low-risk PCa and a long life expectancy .
PSA doubling time in <3 yr or a biopsy progression indicates the need for active intervention .
In men with locally advanced PCa in 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 mostly recommended for patients with localised disease and a long life expectancy with radical prostatectomy ( RP ) shown to be superior to WW in a prospect i ve r and omised trial .
Nerve-sparing RP represents the approach of choice in organ-confined disease ; neoadjuvant and rogen deprivation demonstrates no improvement of outcome variables .
For locally advanced disease , adjuvant ADT for 3 yr results in superior disease-specific and overall survival rates and represents the treatment of choice .
OBJECTIVE Our aim was to present a summary of the 2010 version of the European Association of Urology ( EAU ) guidelines on the screening , diagnosis , and treatment of clinical ly localised cancer of the prostate ( PCa ) .
Current evidence is insufficient to warrant widespread population -based screening by prostate-specific antigen ( PSA ) for PCa .
A systematic prostate biopsy under ultrasound guidance and local anaesthesia is the preferred diagnostic method .