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 .
Addition of radiotherapy to long-term androgen deprivation in locally advanced prostate cancer: an open randomised phase 3 trial.
BACKGROUND Radiotherapy combined with and rogen-deprivation therapy ( ADT ) is superior to radiotherapy alone in localised prostate cancer ; however , data comparing ADT alone are somewhat limited . OBJECTIVE To compare 3-yr ADT plus radiotherapy with ADT alone in locally advanced prostate cancer patients . DESIGN , SETTING , AND PARTICIPANTS A multicentre r and omised open controlled phase 3 trial in 264 histologically confirmed T3 - 4 or pT3N0M0 prostate cancer patients r and omised from March 2000 to December 2003 . INTERVENTION ADT ( 11.25 mg subcutaneous depot injection of leuprorelin every 3 mo for 3 yr ) plus external-beam radiotherapy or ADT alone . Flutamide ( 750 g/d ) was administered for 1 mo . OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS The primary objective was 5 yr progression-free survival ( PFS ) according to clinical or biologic criteria , using the American Society for Therapeutic Radiology and Oncology ( ASTRO ) and the newer ( Phoenix ) definition ( nadir plus 2 ng/ml ) , by intention to treat . Secondary objectives included time to locoregional recurrence and distant metastases , and overall and disease-specific survival . Our Analyses : intent-to-treat analysis , multivariate analyses using a Cox model with a 5 % threshold from univariate analysis , and Kaplan-Meier estimates . RESULTS AND LIMITATIONS  ADT alone was administered to 130 patients and combined therapy to 133 . With a median follow-up of 67 mo , 5-yr PFS was 60.9 % for combined therapy versus 8.5 % with ADT alone ( ASTRO ; p<0.0001 ) , and 64.7 % versus 15.4 % , respectively , for Phoenix ( p<0.0011 ) . Locoregional progression was reported in 9.8 % of combined-therapy patients versus 29.2 % with ADT alone ( p<0.0001 ) and metastatic progression in 3.0 % versus 10.8 % , respectively ( p<0.018 ) . Overall survival was 71.4 % with combined therapy versus 71.5 % with ADT alone ; disease-specific survival was 93.2 % versus 86.2 % . Limitations included the relatively small population and a relatively short follow-up period . CONCLUSIONS Combined therapy strongly favoured improved PFS , locoregional control , and metastasis-free survival . Longer follow-up is needed to assess the potential survival impact
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 .