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 .
Salvage lymph node dissection for prostate cancer nodal recurrence detected by 11C-choline positron emission tomography/computerized tomography.
PURPOSE We report salvage lymph node dissections for prostate cancer nodal recurrence detected by (11)C-choline positron emission tomography/computerized tomography in the setting of increasing prostate specific antigen after radical prostatectomy . MATERIAL S AND METHODS Retrospective chart review was performed for all patients who underwent salvage lymph node dissection for prostate cancer nodal recurrence . Only patients previously treated with radical prostatectomy were included in the study and those with evidence of local recurrence were excluded from analysis . Primary end points included biochemical recurrence , systemic progression and cancer specific mortality . RESULTS From 2009 to 2013 , 52 men underwent salvage lymph node dissection .  Before salvage lymph node dissection  78.8 % ( 41 of 52 ) had some form of therapy after radical prostatectomy . Median age at salvage lymph node dissection was 60 years and median prostate specific antigen was 2.2 ng/ml ( IQR 1.4 - 3.7 ) . The median number of lymph nodes dissected was 21.5 ( IQR 16 - 30 ) and the median number of positive nodes was 3.5 ( IQR 1.2 - 6.5 ) . Since salvage lymph node dissection 46.2 % of the men ( 24 of 52 ) have had no further treatment , 34.6 % ( 18 of 52 ) are on hormonal therapy and 19.2 % ( 10 of 52 ) have received multiple different treatments . At the last followup at a median of 20 months ( IQR 8 - 33 ) , 57.7 % ( 30 of 52 ) had prostate specific antigen remain less than 0.2 ng/ml , 75 % ( 39 of 52 ) remained free of systemic progression and 96.2 % of the men ( 50 of 52 ) were alive . Two patients died of prostate cancer . Three-year biochemical recurrence-free , systemic progression-free and cancer specific survival was 45.5 % , 46.9 % and 92.5 % , respectively . CONCLUSIONS This represents the largest U.S. series of salvage lymph node dissection in the setting of lymph node metastatic prostate cancer after radical prostatectomy . Although followup was short and the study lacked a r and omized control group , salvage lymph node dissection may represent a valid treatment option
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 .