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 .
Prediction of seminal vesicle invasion in prostate cancer: incremental value of adding endorectal MR imaging to the Kattan nomogram.
PURPOSE To retrospectively determine whether endorectal magnetic resonance ( MR ) imaging findings contribute incremental value to the Kattan nomogram for predicting seminal vesicle invasion ( SVI ) in patients with prostate cancer . MATERIAL S AND METHODS The institutional review board issued a waiver of authorization , which included a waiver of informed consent , for this HIPAA-compliant study . From October 2000 through January 2005 , 573 patients ( mean age , 58.3 years ; age range , 36 - 86 years ) underwent endorectal MR imaging before prostate cancer surgery .  The endorectal MR imaging results had been prospect ively interpreted by seven radiologists , and the likelihood of SVI was retrospectively scored on the basis of radiologists ' written reports . MR imaging findings , individual clinical variables ( serum prostate-specific antigen [ PSA ] level , Gleason grade , clinical stage , greatest percentage of cancer in all biopsy cores , percentage of positive cores in all biopsy cores , and perineural invasion ) , and the Kattan nomogram were evaluated with respect to SVI prediction ; surgical pathologic analysis was used as the reference st and ard . Logistic regression and receiver operating characteristic ( ROC ) curve analyses were performed . RESULTS At pathologic analysis , 28 ( 4.9 % ) of 573 patients had SVI . At univariate analysis , endorectal MR imaging results and all clinical variables except the percentage of positive biopsy cores were significantly associated with SVI ( P<.02 ) ; endorectal MR imaging ( 0.76 ) had a larger area under the ROC curve ( AUC ) than any clinical variable ( 0.62 - 0.73 ) . At multivariate analysis , endorectal MR imaging results , Gleason grade , PSA level , and the percentage of cancer in all biopsy cores were significantly associated with SVI ( P < or=.02 ) . The Kattan nomogram plus endorectal MR imaging ( 0.87 ) had a significantly larger ( P<.05 ) AUC than either endorectal MR imaging alone ( 0.76 ) or the Kattan nomogram alone ( 0.80 ) . CONCLUSION The addition of endorectal MR imaging contributes significant incremental value to the Kattan nomogram for predicting SVI
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 .