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 .
Characterization of prostate lesions as benign or malignant at multiparametric MR imaging: comparison of three scoring systems in patients treated with radical prostatectomy.
PURPOSE To compare the subjective Likert score to the Prostate Imaging Reporting and Data System ( PIRADS ) and morphology-location-signal intensity ( MLS ) scores for categorization of prostate lesions as benign or malignant at multiparametric magnetic resonance ( MR ) imaging . MATERIAL S AND METHODS Two hundred fifteen patients who underwent T2-weighted , diffusion-weighted , and dynamic contrast material -enhanced multiparametric MR imaging of the prostate before radical prostatectomy  were included in a prospect i ve data base after they signed the institutional review board-approved forms . Senior readers 1 and 2 prospect ively noted the location , shape , and signal intensity of lesions on MR images from individual pulse sequences and scored each for likelihood of malignancy by using a Likert scale ( range , 1 - 5 ) . A junior reader ( reader 3 ) retrospectively review ed the data base and did the same analysis . The MLS score ( range , 1 - 13 ) was computed by using the readers ' descriptions of the lesions . Then , the three readers again scored the lesions they described by using the PIRADS score ( range , 3 - 15 ) . MLS and PIRADS scores were compared with the Likert score by using their areas under the receiver operating characteristic curves . RESULTS Areas under the receiver operating characteristic curves of the Likert , MLS , and PIRADS scores were 0.81 , 0.77 ( P = .03 ) , and 0.75 ( P = .01 ) for reader 1 ; 0.88 , 0.74 ( P < .0001 ) , and 0.76 ( P < .0001 ) for reader 2 ; and 0.81 , 0.78 ( P = .23 ) , and 0.75 ( P = .01 ) for reader 3 . For diagnosing cancers with Gleason scores greater than or equal to 7 , the Likert score was significantly more accurate than the others , except for the MLS score for reader 3 . Weighted κ values were 0.470 - 0.524 , 0.405 - 0.430 , and 0.378 - 0.441 for the Likert , MLS , and PIRADS scores , respectively . CONCLUSION The Likert score allowed significantly more accurate categorization of prostate lesions on MR images than did the MLS and PIRADS scores
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 .