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 .
Predicting High-Grade Cancer at Ten-Core Prostate Biopsy Using Four Kallikrein Markers Measured in Blood in the ProtecT Study
Background : Many men with elevated prostate-specific antigen ( PSA ) levels in serum do not have aggressive prostate cancer and undergo unnecessary biopsy . Retrospective studies using cryopreserved serum suggest that four kallikrein markers can predict biopsy outcome . Methods : Free , intact and total PSA , and kallikrein-related peptidase 2  were measured in cryopreserved blood from 6129 men with elevated PSA ( ≥3.0ng/mL ) participating in the prospect i ve , r and omized trial Prostate Testing for Cancer and Treatment . Marker levels from 4765 men providing anticoagulated plasma  were incorporated into statistical models to predict any- grade and high- grade ( Gleason score ≥7 ) prostate cancer at 10-core biopsy . The models were corrected for optimism by 10-fold cross validation and independently vali date d using markers measured in serum from 1364 men . All statistical tests were two-sided . Results : The four kallikreins enhanced prostate cancer detection compared with PSA and age alone . Area under the curve ( AUC ) for the four kallikreins was 0.719 ( 95 % confidence interval [ CI ] = 0.704 to 0.734 ) vs 0.634 ( 95 % CI = 0.617 to 0.651 , P < .001 ) for PSA and age alone for any- grade cancer , and 0.820 ( 95 % CI = 0.802 to 0.838 ) vs 0.738 ( 95 % CI = 0.716 to 0.761 ) for high- grade cancer . Using a 6 % risk of high- grade cancer as an illustrative cutoff , for 1000 biopsied men with PSA levels of 3.0ng/mL or higher , the model would reduce the need for biopsy in 428 men , detect 119 high- grade cancers , and delay diagnosis of 14 of 133 high- grade cancers . Models exhibited excellent discrimination on independent validation among men with only serum sample s available for analysis . Conclusions : A statistical model based on kallikrein markers was vali date d in a large prospect i ve study and reduces unnecessary biopsies while delaying diagnosis of high- grade cancers in few men
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 .