Zoledronic acid and denosumab can be used in men with mCRPC and osseous metastases to prevent skeletal-related complications .
PATIENT SUMMARY In men with a rise in their PSA levels after prior local treatment for prostate cancer only , it is important to balance overtreatment against further progression of the disease since survival and quality of life may never be affected in many of these patients .
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 the treatment of relapsing , metastatic , and castration-resistant prostate cancer ( CRPC ) .
EVIDENCE SYNTHESIS Relapse after local therapy is defined by a rising prostate-specific antigen ( PSA ) level > 0.2ng/ml following radical prostatectomy ( RP ) and > 2ng/ml above the nadir after radiation therapy ( RT ) .
And rogen deprivation therapy ( ADT ) remains the basis for treatment of men with metastatic prostate cancer ( PCa ) .
Level 1 evidence for the treatment of metastatic CRPC ( mCRPC ) includes , abiraterone acetate plus prednisone ( AA/P ) , enzalutamide , radium 223 ( Ra 223 ) , docetaxel at 75 mg/m2 every 3 wk and sipuleucel-T. Cabazitaxel , AA/P , enzalutamide , and radium are approved for second-line treatment of CRPC following docetaxel .
CONCLUSIONS The knowledge in the field of advanced and metastatic PCa and CRPC is changing rapidly .
Prostate Gland Lengths and Iceball Dimensions Predict Micturition Functional Outcome Following Salvage Prostate Cryotherapy in Men with Radiation Recurrent Prostate Cancer
Introduction Tissue cryoablation is a potential curative option for solid malignancies , including radiation recurrent prostate cancer ( RRPC ) . Case series of salvage cryotherapy ( SCT ) in RRPC have reported promising disease free survival ( DFS ) outcomes and acceptable toxicity profile . While many men receive SCT , no predictive factors for treatment induced side effects are known . The aim of this study is to vali date the oncologic outcome of SCT in a large multi-centre patient cohort and to identify potential parameters associated with an increased risk of micturition symptoms . Patients and Methods In this retrospective analysis , we studied 283 consecutive patients with RRPC treated by SCT in three independent U.K. centres ( between 2001 and 2011 ) .  Two freeze-thaw cycles of transperineal cryotherapy were performed under transrectal ultrasound guidance by a single surgeon in each of the 3 sites . We analysed clinico-pathological factors against tumour response . Functional outcomes were assessed by continence status and IPSS question naire . Predictive factors for SCT-induced micturition symptoms were analysed in a sub-group ( n = 42 ) of consecutive cases . Results We found that nadir post-SCT PSA levels strongly associated with DFS . The DFS rates at 12- and 36-month were 84 % and 67 % for the ≤1 ng/ml group and 56 % and 14 % for the > 1 ng/ml group , respectively ( p<0.001 ) . Correlative analysis revealed highly significant association between patients ' post-SCT micturition status with prostate gl and and iceball lengths following SCT . Finally , in a reduction model , both gl and length and maximal length of iceball were highly associated with patients ' IPSS outcome ( p<0.001 ) . Conclusion We report the largest European patient cohort treated with SCT for RRPC . Oncologic outcome guided by nadir PSA of < 1 ng/ml is consistent with earlier single-centre series . For the first time , we identified physical parameters to predict micturition symptoms following SCT . Our data will directly assist on-going and future trial design in cryotherapy in prostate cancer
Zoledronic acid and denosumab can be used in men with mCRPC and osseous metastases to prevent skeletal-related complications .
PATIENT SUMMARY In men with a rise in their PSA levels after prior local treatment for prostate cancer only , it is important to balance overtreatment against further progression of the disease since survival and quality of life may never be affected in many of these patients .
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 the treatment of relapsing , metastatic , and castration-resistant prostate cancer ( CRPC ) .
EVIDENCE SYNTHESIS Relapse after local therapy is defined by a rising prostate-specific antigen ( PSA ) level > 0.2ng/ml following radical prostatectomy ( RP ) and > 2ng/ml above the nadir after radiation therapy ( RT ) .
And rogen deprivation therapy ( ADT ) remains the basis for treatment of men with metastatic prostate cancer ( PCa ) .
Level 1 evidence for the treatment of metastatic CRPC ( mCRPC ) includes , abiraterone acetate plus prednisone ( AA/P ) , enzalutamide , radium 223 ( Ra 223 ) , docetaxel at 75 mg/m2 every 3 wk and sipuleucel-T. Cabazitaxel , AA/P , enzalutamide , and radium are approved for second-line treatment of CRPC following docetaxel .
CONCLUSIONS The knowledge in the field of advanced and metastatic PCa and CRPC is changing rapidly .