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 .
Magnetic resonance imaging-ultrasound fusion biopsy for prediction of final prostate pathology.
PURPOSE We explored the impact of magnetic resonance imaging-ultrasound fusion prostate biopsy on the prediction of final surgical pathology . MATERIAL S AND METHODS A total of 54 consecutive men undergoing radical prostatectomy at UCLA after fusion biopsy  were included in this prospect i ve , institutional review board approved pilot study . Using magnetic resonance imaging-ultrasound fusion , tissue was obtained from a 12-point systematic grid ( mapping biopsy ) and from regions of interest detected by multiparametric magnetic resonance imaging ( targeted biopsy ) . A single radiologist read all magnetic resonance imaging , and a single pathologist independently re review ed all biopsy and whole mount pathology , blinded to prior interpretation and matched specimen . Gleason score concordance between biopsy and prostatectomy was the primary end point . RESULTS Mean patient age was 62 years and median prostate specific antigen was 6.2 ng/ml .  Final Gleason score at prostatectomy was 6 ( 13 % ) , 7 ( 70 % ) and 8 - 9 ( 17 % ) . A tertiary pattern was detected in 17 ( 31 % ) men . Of 45 high suspicion ( image grade 4 - 5 ) magnetic resonance imaging targets 32 ( 71 % ) contained prostate cancer . The per core cancer detection rate was 20 % by systematic mapping biopsy and 42 % by targeted biopsy . The highest Gleason pattern at prostatectomy was detected by systematic mapping biopsy in 54 % , targeted biopsy in 54 % and a combination in 81 % of cases . Overall 17 % of cases were up grade d from fusion biopsy to final pathology and 1 ( 2 % ) was down grade d. The combination of targeted biopsy and systematic mapping biopsy was needed to obtain the best predictive accuracy . CONCLUSIONS In this pilot study magnetic resonance imaging-ultrasound fusion biopsy allowed for the prediction of final prostate pathology with greater accuracy than that reported previously using conventional methods ( 81 % vs 40 % to 65 % ) . If confirmed , these results will have important clinical implication
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 .