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 .
Complications after prostate biopsy: data from SEER-Medicare.
PURPOSE More than 1 million prostate biopsies are performed annually among Medicare beneficiaries . We determined the risk of serious complications requiring hospitalization . We hypothesized that with emerging multidrug resistant organisms there may be an increasing risk of infectious complications . MATERIAL S AND METHODS In a 5 % r and om sample of Medicare participants in SEER ( Surveillance , Epidemiology and End Results ) regions from 1991 to 2007 we compared 30-day hospitalization rates and ICD-9 primary diagnosis codes for admissions between 17,472 men who underwent prostate biopsy and a r and om sample of 134,977 controls . Multivariate logistic and Poisson regression were used to examine the risk and predictors of serious infectious and noninfectious complications with time . RESULTS The 30-day hospitalization rate was 6.9 % within 30 days of prostate biopsy , which was substantially higher than the 2.7 % in the control population . After adjusting for age , race , SEER region , year and comorbidities prostate biopsy was associated with a 2.65-fold ( 95 % CI 2.47 - 2.84 ) increased risk of hospitalization within 30 days compared to the control population ( p < 0.0001 ) . The risk of infectious complications requiring hospitalization after biopsy was significantly greater in more recent years ( p(trend ) = 0.001 ) . Among men undergoing biopsy , later year , nonwhite race and higher comorbidity scores were significantly associated with an increased risk of infectious complications . CONCLUSIONS The risk of hospitalization within 30 days of prostate biopsy was significantly higher than in a control population . Infectious complications after prostate biopsy have increased in recent years while the rate of serious noninfectious complications is relatively stable . Careful patient selection for prostate biopsy is essential to minimize the potential harms
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 .