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Prostatic Neoplasms HELP
Based on 56,912 articles published since 2007
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These are the 56912 published articles about Prostatic Neoplasms that originated from Worldwide during 2007-2018.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13 · 14 · 15 · 16 · 17 · 18 · 19 · 20
1 Guideline ACR Appropriateness Criteria 2017

Anonymous3121079 / Coakley, Fergus V / Oto, Aytekin / Alexander, Lauren F / Allen, Brian C / Davis, Brian J / Froemming, Adam T / Fulgham, Pat F / Hosseinzadeh, Keyanoosh / Porter, Christopher / Sahni, V Anik / Schuster, David M / Showalter, Timothy N / Venkatesan, Aradhana M / Verma, Sadhna / Wang, Carolyn L / Remer, Erick M / Eberhardt, Steven C. ·Principal Author, Oregon Health & Science University, Portland, Oregon. Electronic address: coakleyf@ohsu.edu. · Panel Vice-Chair, University of Chicago, Chicago, Illinois. · Emory University Hospital, Atlanta, Georgia. · Duke University Medical Center, Durham, North Carolina. · Mayo Clinic, Rochester, Minnesota. · Urology Clinics of North Texas, Dallas, Texas; American Urological Association. · Wake Forest University School of Medicine, Winston Salem, North Carolina. · Virginia Mason Medical Center, Seattle, Washington; American Urological Association. · Brigham & Women's Hospital, Boston, Massachusetts. · University of Virginia, Charlottesville, Virginia. · University of Texas MD Anderson Cancer Center, Houston, Texas. · University of Cincinnati Medical Center, Cincinnati, Ohio. · University of Washington, Seattle Cancer Care Alliance, Seattle, Washington. · Specialty Chair, Cleveland Clinic, Cleveland, Ohio. · Panel Chair, University of New Mexico, Albuquerque, New Mexico. ·J Am Coll Radiol · Pubmed #28473080.

ABSTRACT: Despite the frequent statement that "most men die with prostate cancer, not of it," the reality is that prostate cancer is second only to lung cancer as a cause of death from malignancy in American men. The primary goal during baseline evaluation of prostate cancer is disease characterization, that is, establishing disease presence, extent (local and distant), and aggressiveness. Prostate cancer is usually diagnosed after the finding of a suspicious serum prostate-specific antigen level or digital rectal examination. Tissue diagnosis may be obtained by transrectal ultrasound-guided biopsy or MRI-targeted biopsy. The latter requires a preliminary multiparametric MRI, which has emerged as a powerful and relatively accurate tool for the local evaluation of prostate cancer over the last few decades. Bone scintigraphy and CT are primarily used to detect bone and nodal metastases in patients found to have intermediate- or high-risk disease at biopsy. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

2 Guideline ACR Appropriateness Criteria 2017

Anonymous3031079 / Hosseinzadeh, Keyanoosh / Oto, Aytekin / Allen, Brian C / Coakley, Fergus V / Friedman, Barak / Fulgham, Pat F / Hartman, Matthew S / Heller, Matthew T / Porter, Christopher / Sahni, V Anik / Sudakoff, Gary S / Verma, Sadhna / Wang, Carolyn L / Yoo, Don C / Remer, Erick M / Eberhardt, Steven C. ·Principal Author, Wake Forest University School of Medicine, Winston-Salem, North Carolina. Electronic address: keyanooshh@gmail.com. · Panel Vice-Chair, The University of Chicago, Chicago, Illinois. · Duke University Medical Center, Durham, North Carolina. · Oregon Health and Science University, Portland, Oregon. · Long Island Jewish Medical Center, New Hyde Park, New York. · Urology Clinics of North Texas, Dallas, Texas; American Urological Association. · Allegheny General Hospital, Pittsburgh, Pennsylvania. · University of Pittsburgh, Pittsburgh, Pennsylvania. · Virginia Mason Medical Center, Seattle, Washington; American Urological Association. · Brigham & Women's Hospital, Boston, Massachusetts. · Medical College of Wisconsin, Milwaukee, Wisconsin. · University of Cincinnati Medical Center, Cincinnati, Ohio. · University of Washington, Seattle Cancer Care Alliance, Seattle, Washington. · Rhode Island Medical Imaging Inc, East Providence, Rhode Island. · Specialty Chair, Cleveland Clinic, Cleveland, Ohio. · Panel Chair, University of New Mexico, Albuquerque, New Mexico. ·J Am Coll Radiol · Pubmed #28473071.

ABSTRACT: Most men with hematospermia or hemospermia (HS) are young (<40 years of age), presenting with transient or episodic HS without other signs or symptoms of disease. The condition is self-limiting in most cases and idiopathic in nature. When a cause can be identified, infections of the urogenital tract are the most common. Imaging does not play a role in this patient population. In older men (>40 years of age), clinical screening for prostate cancer is advised. Furthermore, when HS is persistent or has symptoms, causes include obstruction or stricture at the level of the verumontanum, calcifications or calculi in the prostate, ejaculatory ducts or seminal vesicles, and cysts arising within these structures. Noninvasive imaging, predominantly transrectal ultrasound (TRUS) and MRI, can be used in men of any age with persistent or refractory HS, or other associated symptoms or signs. TRUS is considered as the first-line imaging with MRI used when TRUS is inconclusive or negative. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer-reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

3 Guideline [Consensus of prostate cancer screening]. 2017

Anonymous7270905. · ·Zhonghua Wai Ke Za Zhi · Pubmed #28464572.

ABSTRACT: The incidence of prostate cancer is increasing rapidly in China, the clinical stage of prostate cancer patients is comparatively late and the overall survival rate is inferior to that reported in the developed countries. Prostate cancer screening is an effective measure to reduce the risk of death through early detection. In order to identify the best way of prostate cancer screening in China, the Chinese Anti-Cancer Association Genitourinary Cancer Committee Prostate Cancer Working Group reviewed all published data concerning the benefits and harms of screening for prostate caner and created the consensus. The consensus include the following points: screening asymptomatic men for prostate cancer by prostate specific antigen(PSA)testing in the general population is the potential measure to reduce mortality rates through early detection, PSA testing should be offered earlier in men with life expectancy over 10 years and men at high risk of prostate cancer.

4 Guideline Brachytherapy for Patients With Prostate Cancer: American Society of Clinical Oncology/Cancer Care Ontario Joint Guideline Update. 2017

Chin, Joseph / Rumble, R Bryan / Kollmeier, Marisa / Heath, Elisabeth / Efstathiou, Jason / Dorff, Tanya / Berman, Barry / Feifer, Andrew / Jacques, Arthur / Loblaw, D Andrew. ·Joseph Chin, London Health Sciences Centre, London; Andrew Feifer, Trillium Health Partners' Fidani Cancer Centre, University Health Network, Mississauga; Arthur Jacques, Patient Representative; D. Andrew Loblaw, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Marisa Kollmeier, Memorial Sloan Kettering Cancer Center, New York, NY; Elisabeth Heath, Karmanos Cancer Institute, Detroit, MI; Jason Efstathiou, Massachusetts General Hospital, Boston, MA; Tanya Dorff, USC Norris Cancer Center, Los Angeles, CA; and Barry Berman, Broward Health, Fort Lauderdale, FL. ·J Clin Oncol · Pubmed #28346805.

ABSTRACT: Purpose To jointly update the Cancer Care Ontario guideline on brachytherapy for patients with prostate cancer to account for new evidence. Methods An Update Panel conducted a targeted systematic literature review and identified more recent randomized controlled trials comparing dose-escalated external beam radiation therapy (EBRT) with brachytherapy in men with prostate cancer. Results Five randomized controlled trials provided the evidence for this update. Recommendations For patients with low-risk prostate cancer who require or choose active treatment, low-dose rate brachytherapy (LDR) alone, EBRT alone, and/or radical prostatectomy (RP) should be offered to eligible patients. For patients with intermediate-risk prostate cancer choosing EBRT with or without androgen-deprivation therapy, brachytherapy boost (LDR or high-dose rate [HDR]) should be offered to eligible patients. For low-intermediate risk prostate cancer (Gleason 7, prostate-specific antigen < 10 ng/mL or Gleason 6, prostate-specific antigen, 10 to 20 ng/mL), LDR brachytherapy alone may be offered as monotherapy. For patients with high-risk prostate cancer receiving EBRT and androgen-deprivation therapy, brachytherapy boost (LDR or HDR) should be offered to eligible patients. Iodine-125 and palladium-103 are each reasonable isotope options for patients receiving LDR brachytherapy; no recommendation can be made for or against using cesium-131 or HDR monotherapy. Patients should be encouraged to participate in clinical trials to test novel or targeted approaches to this disease. Additional information is available at www.asco.org/Brachytherapy-guideline and www.asco.org/guidelineswiki .

5 Guideline Sexual Rehabilitation After Treatment For Prostate Cancer-Part 2: Recommendations From the Fourth International Consultation for Sexual Medicine (ICSM 2015). 2017

Salonia, Andrea / Adaikan, Ganesh / Buvat, Jacques / Carrier, Serge / El-Meliegy, Amr / Hatzimouratidis, Kostas / McCullough, Andrew / Morgentaler, Abraham / Torres, Luiz Otavio / Khera, Mohit. ·Università Vita-Salute San Raffaele, Milan, Italy. Electronic address: salonia.andrea@hsr.it. · Section of Sexual Medicine, Obstetrics and Gynaecology, National University Hospital, National University of Singapore, Singapore. · Centre d'études et de traitement de la pathologie de l'appareil reproducteur (CETPARP), Lille, France. · Department of Urology, McGill University, Montreal, QC, Canada. · Department of Andrology, Sexology and STDs, Faculty of Medicine, Cairo University, Cairo, Egypt. · Second Department of Urology, Aristotle University of Thessaloniki, Pefka Thessaloniki, Greece. · Division of Urology, Albany Medical College, Albany, NY, USA. · Men's Health Boston and Harvard Medical School, Boston, MA, USA. · Centro Universitário UniBH, Belo Horizonte, Minas Gerais, Brazil. · Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA. ·J Sex Med · Pubmed #28262100.

ABSTRACT: INTRODUCTION: Sexual dysfunction is common in patients after radical prostatectomy (RP) for prostate cancer. AIM: To provide the International Consultation for Sexual Medicine (ICSM) 2015 recommendations concerning management strategies for post-RP erectile function impairment and to analyze post-RP sexual dysfunction other than erectile dysfunction. METHODS: A literature search was performed using Google and PubMed database for English-language original and review articles published up to August 2016. MAIN OUTCOME MEASURES: Levels of evidence (LEs) and grades of recommendations (GRs) are provided based on a thorough analysis of the literature and committee consensus. RESULTS: Nine recommendations are provided by the ICSM 2015 committee on sexual rehabilitation after RP. Recommendation 6 states that the recovery of postoperative erectile function can take several years (LE = 2, GR = C). Recommendation 7 states there are conflicting data as to whether penile rehabilitation with phosphodiesterase type 5 inhibitors improves recovery of spontaneous erections (LE = 1, GR = A). Recommendation 8 states that the data are inadequate to support any specific regimen as optimal for penile rehabilitation (LE = 3, GR = C). Recommendation 9 states that men undergoing RP (any technique) are at risk of sexual changes other than erectile dysfunction, including decreased libido, changes in orgasm, anejaculation, Peyronie-like disease, and changes in penile size (LE = 2, GR = B). CONCLUSION: This article discusses Recommendations 6 to 9 of the ICSM 2015 committee on sexual rehabilitation after RP. Salonia A, Adaikan G, Buvat J, et al. Sexual Rehabilitation After Treatment For Prostate Cancer-Part 2: Recommendations From the Fourth International Consultation for Sexual Medicine (ICSM 2015). J Sex Med 2017;14:297-315.

6 Guideline Sexual Rehabilitation After Treatment for Prostate Cancer-Part 1: Recommendations From the Fourth International Consultation for Sexual Medicine (ICSM 2015). 2017

Salonia, Andrea / Adaikan, Ganesh / Buvat, Jacques / Carrier, Serge / El-Meliegy, Amr / Hatzimouratidis, Kostas / McCullough, Andrew / Morgentaler, Abraham / Torres, Luiz Otavio / Khera, Mohit. ·Università Vita-Salute San Raffaele, Milan, Italy. Electronic address: salonia.andrea@hsr.it. · Section of Sexual Medicine, Obstetrics and Gynaecology, National University Hospital, National University of Singapore, Singapore. · Centre d'études et de traitement de la pathologie de l'appareil reproducteur (CETPARP), Lille, France. · Department of Urology, McGill University, Montreal, QC, Canada. · Department of Andrology, Sexology and STDs, Faculty of Medicine, Cairo University, Cairo, Egypt. · Second Department of Urology, Aristotle University of Thessaloniki, Pefka Thessaloniki, Greece. · Division of Urology, Albany Medical College, Albany, NY, USA. · Men's Health Boston and Harvard Medical School, Boston, MA, USA. · Centro Universitário UniBH, Belo Horizonte, Minas Gerais, Brazil. · Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA. ·J Sex Med · Pubmed #28262099.

ABSTRACT: INTRODUCTION: Sexual dysfunction is common in patients after radical prostatectomy (RP) for prostate cancer. AIM: To provide the International Consultation for Sexual Medicine (ICSM) 2015 recommendations concerning prevention and management strategies for post-RP erectile function impairment in terms of preoperative patient characteristics and intraoperative factors that could influence erectile function recovery. METHODS: A literature search was performed using Google and PubMed databases for English-language original and review articles published up to August 2016. MAIN OUTCOME MEASURES: Levels of evidence (LEs) and grades of recommendations (GRs) based on a thorough analysis of the literature and committee consensus. RESULTS: Nine recommendations are provided by the ICSM 2015 committee on sexual rehabilitation after RP. Recommendation 1 states that clinicians should discuss the occurrence of postsurgical erectile dysfunction (temporary or permanent) with every candidate for RP (expert opinion, clinical principle). Recommendation 2 states that validated instruments for assessing erectile function recovery such as the International Index of Erectile Function and Expanded Prostate Cancer Index Composite questionnaires are available to monitor EF recovery after RP (LE = 1, GR = A). Recommendation 3 states there is insufficient evidence that a specific surgical technique (open vs laparoscopic vs robot-assisted radical prostatectomy) promotes better results in postoperative EF recovery (LE = 2, GR = C). Recommendation 4 states that recognized predictors of EF recovery include but are not limited to younger age, preoperative EF, and bilateral nerve-sparing surgery (LE = 2, GR = B). Recommendation 5 states that patients should be informed about key elements of the pathophysiology of postoperative erectile dysfunction, such as nerve injury and cavernous venous leak (expert opinion, clinical principle). CONCLUSIONS: This article discusses Recommendations 1 to 5 of the ICSM 2015 committee on sexual rehabilitation after RP. Salonia A, Adaikan G, Buvat J, et al. Sexual Rehabilitation After Treatment for Prostate Cancer-Part 1: Recommendations From the Fourth International Consultation for Sexual Medicine (ICSM 2015). J Sex Med 2017;14:285-296.

7 Guideline Italian Prostate Biopsies Group: 2016 Updated Guidelines Insights. 2017

Fandella, Andrea / Scattoni, Vincenzo / Galosi, Andrea / Pepe, Pietro / Fiorentino, Michelangelo / Gaudiano, Caterina / Giampaoli, Marco / Gunelli, Roberta / Martino, Pasquale / Montanaro, Vittorino / Montironi, Rodolfo / Pierangeli, Tiziana / Stabile, Armando / Bertaccini, Alessandro. ·Department of Urology, Giovanni XXIII Clinic, Monastier di Treviso, Treviso, Italy. · Department of Urology, San Raffaele Hospital, Milan, Italy scattoni.vincenzo@hsr.it. · Institute of Urology, Marche Polytechnic University, Riuniti Hospital, Ancona, Italy. · Department of Urology, Canizzaro Hospital, Catania, Italy. · Department of Pathology, F. Addari Institute of Oncology, S. Orsola Hospital, Bologna, Italy. · Department of Radiology, S. Orsola - Malpighi Hospital, University of Bologna, Bologna, Italy. · Institute of Urology, S. Orsola - Malpighi Hospital, University of Bologna, Bologna, Italy. · Department of Urology, Hospital of Forlì, Forlì, Italy. · Department of Urology, University of Bari, Bari, Italy. · Department of Urology, Federico II University Hospital, Naples, Italy. · Institute of Pathology, Marche Polytechnic University, Ancona, Italy. · Prostate Cancer Prevention Unit, Department of Urology, INRCA, Ancona, Italy. · Department of Urology, San Raffaele Hospital, Milan, Italy. ·Anticancer Res · Pubmed #28179286.

ABSTRACT: AIM: To present a summary of the updated guidelines of the Italian Prostate Biopsies Group following the best recent evidence of the literature. MATERIALS AND METHODS: A systematic review of the new data emerging from 2012-2015 was performed by a panel of 14 selected Italian experts in urology, pathology and radiology. The experts collected articles published in the English-language literature by performing a search using Medline, EMBASE and the Cochrane Library database. The articles were evaluated using a systematic weighting and grading of the level of the evidence according to the Grading of Recommendations Assessment, Development and Evaluation framework system. RESULTS: An initial prostate biopsy is strongly recommended when i) prostate specific antigen (PSA) >10 ng/ml, ii) digital rectal examination is abnormal, iii) multiparametric magnetic resonance imaging (mpMRI) has a Prostate Imaging Reporting and Data System (PIRADS) ≥4, even if it is not recommended. The use of mpMRI is strongly recommended only in patients with previous negative biopsy. At least 12 cores should be taken in each patient plus targeted (fusion or cognitive) biopsies of suspicious area (at mpMRI or transrectal ultrasound). Saturation biopsies are optional in all settings. The optimal strategy for reducing infection complications is still a controversial topic and the instruments to reduce them are actually weak. The adoption of Gleason grade groups in adjunction to the Gleason score when reporting prostate biopsy results is advisable. CONCLUSION: These updated guidelines and recommendations are intended to assist physicians and patients in the decision-making regarding when and how to perform a prostatic biopsy.

8 Guideline Contemporary Gleason Grading of Prostatic Carcinoma: An Update With Discussion on Practical Issues to Implement the 2014 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma. 2017

Epstein, Jonathan I / Amin, Mahul B / Reuter, Victor E / Humphrey, Peter A. ·*Department of Pathology, Urology, and Oncology, The Johns Hopkins Medical Institutions, Baltimore, MD †Department of Pathology and Laboratory Medicine, University of Tennessee Health Science Center, Memphis, TN ‡Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY §Department of Pathology, Yale School of Medicine, New Haven, CT. ·Am J Surg Pathol · Pubmed #28177964.

ABSTRACT: The primary proceedings of the 2014 International Society of Urological Pathology Grading Conference were published promptly in 2015 and dealt with: (1) definition of various grading patterns of usual acinar carcinoma, (2) grading of intraductal carcinoma; and (3) support for the previously proposed new Grade Groups. The current manuscript in addition to highlighting practical issues to implement the 2014 recommendations, provides an updated perspective based on numerous studies published after the 2014 meeting. A major new recommendation that came from the 2014 Consensus Conference was to report percent pattern 4 with Gleason score 7 in both needle biopsies and radical prostatectomy (RP) specimens. This manuscript gives the options how to record percentage pattern 4 and under which situations recording this information may not be necessary. Another consensus from the 2014 meeting was to replace the term tertiary-grade pattern with minor high-grade pattern. Minor high-grade indicates that the term tertiary should not merely be just the third most common pattern but that it should be minor or limited in extent. Although a specific cutoff of 5% was not voted on in the 2014 Consensus meeting, the only quantification of minor high-grade pattern that has been used in the literature with evidence-based data correlating with outcome has been the 5% cutoff. At the 2014 Consensus Conference, there was agreement that the grading rule proposed in the 2005 Consensus Conference on needle biopsies be followed, that tertiary be not used, and that the most common and highest grade patterns be summed together as the Gleason score. Therefore, the term tertiary or minor high-grade pattern should only be used in RP specimens when there are 3 grade patterns, such as with 3+4=7 or 4+3=7 with <5% Gleason pattern 5. It was recommended at the 2014 Conference that for the foreseeable future, the new Grade Groups would be reported along with the Gleason system. The minor high-grade patterns do not change the Grade Groups, such that in current practice one would, for example, report Gleason score 3+4=7 (Grade Group 2) with minor (tertiary) pattern 5. It was discussed at the 2014 Consensus Conference how minor high-grade patterns would be handled if Grade Groups 1 to 5 eventually were to replace Gleason scores 2 to 10. In the above example, it could be reported as Grade Group 2 with minor high-grade pattern or potentially this could be abbreviated to Grade Group 2+. The recommendation from the 2014 meeting was the same as in the 2005 consensus for grading separate cores with different grades: assign individual Gleason scores to separate cores as long as the cores were submitted in separate containers or the cores were in the same container yet specified by the urologist as to their location (ie, by different color inks). It is the practice of the majority of the authors of this manuscript that if the cores are submitted in a more specific anatomic manner than just left versus right (ie, per sextant site, MRI targets, etc.), that the grade of multiple cores in the same jar from that specific site are averaged together, given they are from the same location within the prostate. In cases with multiple fragmented cores in a jar, there was agreement to give a global Gleason score for that jar. The recommendation from the 2014 meeting was the same as in the 2005 consensus for grading separate nodules of cancer in RP specimens: one should assign a separate Gleason score to each dominant nodule(s). In the unusual occurrence of a nondominant nodule (ie, smaller nodule) that is of higher stage, one should also assign a grade to that nodule. If one of the smaller nodules is the highest grade focus within the prostate, the grade of this smaller nodule should also be recorded. An emerging issue in the studies and those published subsequent to the meeting was that cribriform morphology is associated with a worse prognosis than poorly formed or fused glands and in the future may be specifically incorporated into grading practice. We believe that the results from the 2014 Consensus Conference and the updates provided in this paper are vitally important to our specialty to promote uniformity in reporting of prostate cancer grade and in the contemporary management of prostate cancer.

9 Guideline Bone Health and Bone-targeted Therapies for Prostate Cancer: a Programme in Evidence-based Care - Cancer Care Ontario Clinical Practice Guideline. 2017

Alibhai, S M H / Zukotynski, K / Walker-Dilks, C / Emmenegger, U / Finelli, A / Morgan, S C / Hotte, S J / Winquist, E / Anonymous3640896. ·Department of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada. Electronic address: ccopgi@mcmaster.ca. · Departments of Medicine and Radiology, McMaster University, Hamilton, Ontario, Canada. Electronic address: ccopgi@mcmaster.ca. · Department of Oncology, Program in Evidence-Based Care, McMaster University, Hamilton, Ontario, Canada. · Department of Medicine, Division of Medical Oncology, University of Toronto, Odette Cancer Centre, Toronto, Ontario, Canada. · Department of Surgery, Division of Urology, University of Toronto, Princess Margaret Hospital, Toronto, Ontario, Canada. · Department of Radiology, Division of Radiation Oncology, University of Ottawa, The Ottawa Hospital Cancer Centre, Ottawa, Ontario, Canada. · Department of Oncology, Division of Medical Oncology, McMaster University, Juravinski Cancer Centre, Hamilton, Ontario, Canada. · Department of Oncology, Division of Medical Oncology, Western University, London Health Sciences Centre, London, Ontario, Canada. ·Clin Oncol (R Coll Radiol) · Pubmed #28169118.

ABSTRACT: AIMS: To make recommendations with respect to bone health and bone-targeted therapies in men with prostate cancer. MATERIALS AND METHODS: A systematic review was carried out by searching MEDLINE, EMBASE and the Cochrane Library from inception to January 2016. Systematic reviews and randomised-controlled trials were considered for inclusion if they involved therapies directed at improving bone health or outcomes such as skeletal-related events, pain and quality of life in patients with prostate cancer either with or without metastases to bone. Therapies included medications, supplements or lifestyle modifications alone or in combination and were compared with placebo, no treatment or other agents. Disease-targeted agents such as androgen receptor-targeted and chemotherapeutic agents were excluded. Recommendations were reviewed by internal and external review groups. RESULTS: In men with prostate cancer receiving androgen deprivation therapy, baseline bone mineral density testing is encouraged. Denosumab should be considered for reducing the risk of fracture in men on androgen deprivation therapy with an increased fracture risk. Bisphosphonates were effective in improving bone mineral density, but the effect on fracture was inconclusive. No medication is recommended to prevent the development of first bone metastasis. Denosumab and zoledronic acid are recommended for preventing or delaying skeletal-related events in men with metastatic castration-resistant prostate cancer. Radium-223 is recommended for reducing symptomatic skeletal events and prolonging survival in men with symptomatic metastatic castration-resistant prostate cancer. CONCLUSIONS: The recommendations represent a current standard of care that is feasible to implement, with outcomes valued by clinicians and patients.

10 Guideline The American College of Radiology and the American Brachytherapy Society practice parameter for the performance of low-dose-rate brachytherapy. 2017

Viswanathan, Akila N / Erickson, Beth A / Ibbott, Geoffrey S / Small, William / Eifel, Patricia J. ·The Johns Hopkins Oncology Center, Boston, MA, USA. Electronic address: njamiolkowski@acr.org. · Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI, USA. · Department of Radiation Physics, Anderson Cancer Center, Houston, TX, USA. · Loyola University, Chicago, IL. ·Brachytherapy · Pubmed #28109633.

ABSTRACT: Brachytherapy is the use of radionuclides to treat malignancies or benign conditions by means of a radiation source placed close to or into the tumor or treatment site. This practice parameter refers only to the use of radionuclide brachytherapy. Brachytherapy alone or combined with external beam therapy plays an important role in the management and treatment of patients with cancer. Low-dose-rate (LDR) brachytherapy has traditionally been used for treating prostate, head and neck, breast, cervical, and endometrial cancers as well as obstructive bile duct, esophageal, or bronchial lesions. It has been practiced for over a century with a variety of sources including radium-226, cesium-137, and, more recently, iridium- 192, iodine-125, and palladium-103. Low-dose-rate (LDR) brachytherapy can be given as interstitial, intracavitary, intraluminal, and/or plesiotherapy to a wide variety of treatment sites. This practice parameter addresses sealed sources as they are used for LDR brachytherapy. It is recognized that unsealed sources (e.g., yttrium-90) are also a form of LDR brachytherapy.

11 Guideline The American College of Radiology and the American Brachytherapy Society practice parameter for transperineal permanent brachytherapy of prostate cancer. 2017

Bittner, Nathan H J / Orio, Peter F / Merrick, Gregory S / Prestidge, Bradley R / Hartford, Alan Charles / Rosenthal, Seth A. ·Tacoma Valley Radiation Oncology Centers, Tacoma, WA, USA. Electronic address: njamiolkowski@acr.org. · Department of Radiation Oncology, Brigham and Women's Hospital, Lebanon, NH, USA; Dana Farber/Brigham & Women's Cancer Centers, Weymouth, MA, USA. · Schliffer Cancer Center, Wheeling Hospital Medical Park, Wheeling, WV, USA. · Department of Radiation Oncology, Bon Secours Cancer Institute, Norfolk, VA, USA. · Dartmouth-Hitchcock Medical Center. · Roseville Radiation Oncology, Sutter Radiation Oncology Center, Roseville, CA, USA. ·Brachytherapy · Pubmed #28109632.

ABSTRACT: Transperineal permanent brachytherapy is a safe and effective treatment option for patients with organ-confined prostate cancer. Careful adherence to established brachytherapy standards has been shown to improve the likelihood of procedural success and reduce the incidence of treatment-related morbidity. A collaborative effort of the American College of Radiology (ACR) and the American Brachytherapy Society (ABS) has produced practice parameters for LDR prostate brachytherapy. These practice parameters define the qualifications and responsibilities of all the involved personnel, including the radiation oncologist, physicist and dosimetrist. Factors with respect to patient selection and appropriate use of supplemental treatment modalities such as external beam radiation and androgen suppression therapy are discussed. Logistics with respect to the brachytherapy implant procedure, the importance of dosimetric guidelines, and attention to radiation safety procedures and documentation are presented. Adherence to these parameters can be part of ensuring quality and safety in a successful prostate brachytherapy program.

12 Guideline ACR Appropriateness Criteria® Locally Advanced, High-Risk Prostate Cancer. 2017

McLaughlin, Patrick W / Liss, Adam L / Nguyen, Paul L / Assimos, Dean G / D'Amico, Anthony V / Gottschalk, Alexander R / Gustafson, Gary S / Keole, Sameer R / Liauw, Stanley L / Lloyd, Shane / Movsas, Benjamin / Prestidge, Bradley R / Showalter, Timothy N / Taira, Al V / Vapiwala, Neha / Davis, Brian J / Anonymous850893. ·*University of Michigan, Novi ∥William Beaumont Hospital, Troy ††Henry Ford Health System, Detroit, MI †Dana-Farber Cancer Institute/Brigham and Women's Hospital, American Society of Clinical Oncology, Boston, MA ‡University of Alabama School of Medicine, Birmingham, AL, American Urological Association §University of California San Francisco, San Francisco ∥∥Mills Peninsula Hospital, San Mateo, CA ¶Mayo Clinic, Scottsdale, AZ #The University of Chicago Medical Center, Chicago, IL **Huntsman Cancer Hospital, Salt Lake City, UT ‡‡Bon Secours Cancer Institute, Norfolk §§University of Virginia, Charlottesville, VA ¶¶University of Pennsylvania, Philadelphia, PA ##Mayo Clinic, Rochester, MN. ·Am J Clin Oncol · Pubmed #28059930.

ABSTRACT: PURPOSE: To present the most updated American College of Radiology consensus guidelines formed from an expert panel on treatment of locally advanced, high-risk prostate cancer METHODS:: The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer-reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. RESULTS: The panel summarized the most recent and relevant literature on the topic and voted on 4 clinical variants illustrating the appropriate management of locally advanced, high-risk cancer. Numerical rating and commentary reflecting the panel consensus was given for each treatment approach in each variant. CONCLUSIONS: Aggressive local approaches including surgery followed by adjuvant XRT, beam combined with androgen deprivation therapy, and beam combined with brachytherapy have resulted in unpresented success in locally advanced, high-risk prostate cancer. By combining most recent medical literature and expert opinion, this guideline can aid clinicians in the appropriate integration of available therapeutic modalities.

13 Guideline ACR appropriateness criteria: Permanent source brachytherapy for prostate cancer. 2017

Davis, Brian J / Taira, Al V / Nguyen, Paul L / Assimos, Dean G / D'Amico, Anthony V / Gottschalk, Alexander R / Gustafson, Gary S / Keole, Sameer R / Liauw, Stanley L / Lloyd, Shane / McLaughlin, Patrick W / Movsas, Benjamin / Prestidge, Bradley R / Showalter, Timothy N / Vapiwala, Neha. ·Department of Radiation Oncology, Mayo Clinic, Rochester, MN. Electronic address: davis.brian@mayo.edu. · Dorothy Schneider Cancer Center, San Mateo, CA. · Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, MA. · Department of Urology, University of Alabama School of Medicine, Birmingham, AL; American Urological Association, Linthicum, MD. · Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, MA; American Society of Clinical Oncology, Alexandria, VA. · Department of Radiation Oncology, University of California San Francisco, San Francisco, CA. · Radiation Oncology, William Beaumont Hospital, Troy, MI. · Department of Radiation Oncology, Mayo Clinic Scottsdale, Phoenix, AZ. · Department of Radiation and Cellular Oncology, The University of Chicago Medical Center, Chicago, IL. · Department of Radiation Oncology, Huntsman Cancer Hospital, Salt Lake City, UT. · Department of Radiation Oncology, University of Michigan, Novi, MI. · Department of Radiation Oncology, Henry Ford Health System, Detroit, MI. · Bon Secours Cancer Institute, Norfolk, VA. · Department of Radiation Oncology, University of Virginia, Charlottesville, VA. · Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA. ·Brachytherapy · Pubmed #27964905.

ABSTRACT: PURPOSE: To provide updated American College of Radiology (ACR) appropriateness criteria for transrectal ultrasound-guided transperineal interstitial permanent source brachytherapy. METHODS AND MATERIALS: The ACR appropriateness criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 3 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. RESULTS: Permanent prostate brachytherapy (PPB) is a treatment option for appropriately selected patients with localized prostate cancer with low to very high risk disease. PPB monotherapy remains an appropriate and effective curative treatment for low-risk prostate cancer patients demonstrating excellent long-term cancer control and acceptable morbidity. PPB monotherapy can be considered for select intermediate-risk patients with multiparametric MRI useful in evaluation of such patients. High-risk patients treated with PPB should receive supplemental external beam radiotherapy (EBRT) along with androgen deprivation. Similarly, patients with involved pelvic lymph nodes may also be considered for such combined treatment but reported long-term outcomes are limited. Computed tomography-based postimplant dosimetry completed within 60 days of PPB is essential for quality assurance. PPB may be considered for treatment of local recurrence after EBRT but is associated with an increased risk of toxicity. CONCLUSIONS: Updated appropriateness criteria for patient evaluation, selection, treatment, and postimplant dosimetry are given. These criteria are intended to be advisory only with the final responsibility for patient care residing with the treating clinicians.

14 Guideline [CCAFU french national guidelines 2016-2018 on prostate cancer]. 2016

Rozet, F / Hennequin, C / Beauval, J-B / Beuzeboc, P / Cormier, L / Fromont, G / Mongiat-Artus, P / Ouzzane, A / Ploussard, G / Azria, D / Brenot-Rossi, I / Cancel-Tassin, G / Cussenot, O / Lebret, T / Rebillard, X / Soulié, M / Renard-Penna, R / Méjean, A. ·Comité de cancérologie de l'Association française d'urologie, groupe prostate, maison de l'urologie, 11 rue Viète, 75017 Paris, France. ·Prog Urol · Pubmed #27846936.

ABSTRACT: OBJECTIVES: The purpose of the guidelines national committee CCAFU was to propose updated french guidelines for localized and metastatic prostate cancer (PCa). METHODS: A Medline search was achieved between 2013 and 2016, as regards diagnosis, options of treatment and follow-up of PCa, to evaluate different references with levels of evidence. RESULTS: Epidemiology, classification, staging systems, diagnostic evaluation are reported. Disease management options are detailed. Recommandations are reported according to the different clinical situations. Active surveillance is a major option in low risk PCa. Radical prostatectomy remains a standard of care of localized PCa. The three-dimensional conformal radiotherapy is the technical standard. A dose of > 74Gy is recommended. Moderate hypofractionation provides short-term biochemical control comparable to conventional fractionation. In case of intermediate risk PCa, radiotherapy can be combined with short-term androgen deprivation therapy (ADT). In case of high risk disease, long-term ADT remains the standard of care. ADT is the backbone therapy of metastatic disease. In men with metastases at first presentation, upfront chemotherapy combined with ADT should be considered as a new standard. In case of metastatic castration-resistant PCa (mCRPC), new hormonal treatments and chemotherapy provide a better control of tumor progression and increase survival. CONCLUSIONS: These updated french guidelines will contribute to increase the level of urological care for the diagnosis and treatment for prostate cancer. © 2016 Elsevier Masson SAS. All rights reserved.

15 Guideline [Prevention of radio-induced cancers]. 2016

Cosset, J-M / Chargari, C / Demoor, C / Giraud, P / Helfre, S / Mornex, F / Mazal, A. ·Département d'oncologie/radiothérapie, institut Curie, 26, rue d'Ulm, 75005 Paris, France. Electronic address: jeanmarc.cosset@gmail.com. · Service de curiethérapie, institut Gustave-Roussy, 114, rue Édouard-Vaillant, 94800 Villejuif, France; Institut de recherche biomédicale des armées, 91223 Brétigny-sur-Orge, France. · Département de radiothérapie, institut de cancérologie de l'Ouest, boulevard J.-Monod, 44800 Saint-Herblain, Nantes, France; Unité Inserm 1018, 114, rue Édouard-Vaillant, 94805 Villejuif, France. · Hôpital européen Georges-Pompidou, université Paris-Descartes, Paris-Cité Sorbonne, 20, rue Leblanc, 75015 Paris, France. · Département d'oncologie/radiothérapie, institut Curie, 26, rue d'Ulm, 75005 Paris, France. · Département d'oncologie radiothérapie, centre hospitalier Lyon-Sud, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, Lyon, France. ·Cancer Radiother · Pubmed #27523416.

ABSTRACT: The article deals with the prevention of cancers only directly related to therapeutic radiation which are distinguished from "secondary cancer". The consideration of the risk of radiation-induced cancers after radiation therapy, although it is fortunately rare events, has become indispensable today. With a review of the literature, are detailed the various involved parameters. The age of the irradiated patient is one of the main parameters. The impact of the dose is also discussed based on the model used, and based on clinical data. Other parameters defining a radiation treatment are discussed one after the other: field with the example of Hodgkin's disease, the type of radiation and the participation of secondary neutrons, spreading and splitting. All these parameters are discussed according to each organ whose sensitivity is different. The article concludes with a list of recommendations to reduce the risk of radio-induced cancers. Even with the advent of conformal radiotherapy, intensity modulation, the modulated volume arctherapy, and the development of specific machinery for the extra-cranial stereotactic, the radiation therapist must consider this risk and use of reasonable and justified control imaging. Although they constitute a small percentage of cancers that occur secondarily after a first malignant tumor, radiation-induced cancers, can not and must not be concealed or ignored and justify regular monitoring over the long term, precisely adapted on the described parameters.

16 Guideline [Prostate cancer brachytherapy]. 2016

Pommier, P / Guérif, S / Peiffert, D / Créhange, G / Hannoun-Lévi, J-M / de Crevoisier, R. ·Département de radiothérapie, centre Léon-Bérard, 28, rue Laennec, 69373 Lyon cedex 8, France. · Département de radiothérapie, CHU de Poitiers, 350, avenue Jacques-Cœur, 86000 Poitiers, France. · Département de radiothérapie, institut de cancérologie de Lorraine Alexis-Vautrin, 6, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France. · Département de radiothérapie, centre Georges-François-Leclerc, 1, rue Professeur-Marion, BP 77980, 21079 Dijon cedex, France. · Département de radiothérapie oncologie, centre Antoine-Lacassagne, université Nice-Sophia, 33, avenue de Valombrose, 06000 Nice, France. · Département de radiothérapie, centre régional de lutte contre le cancer Eugène-Marquis, avenue Bataille-Flandres-Dunkerque, 35042 Rennes, France. Electronic address: r.de-crevoisier@rennes.unicancer.fr. ·Cancer Radiother · Pubmed #27523412.

ABSTRACT: Prostate brachytherapy techniques are described, concerning both Iodine 125 high dose rate brachytherapy. The following parts are presented: brachytherapy indications, technical description, immediate postoperative management and post-treatment evaluation, and 4 to 6 weeks as well as long-term follow-up.

17 Guideline [Prostate cancer external beam radiotherapy]. 2016

de Crevoisier, R / Pommier, P / Latorzeff, I / Chapet, O / Chauvet, B / Hennequin, C. ·Département de radiothérapie, centre régional de lutte contre le cancer Eugène-Marquis, avenue de la Bataille-Flandres-Dunkerque, 35042 Rennes, France. Electronic address: r.de-crevoisier@rennes.unicancer.fr. · Département de radiothérapie, centre régional de lutte contre le cancer Léon-Bérard, 28, rue Laennec, 69373 Lyon cedex 8, France. · Service de radiothérapie, groupe Oncorad-Garonne, clinique Pasteur, l'Atrium, 1, rue de la Petite-Vitesse, 31000 Toulouse, France. · Département de radiothérapie, centre hospitalier Lyon-Sud, hospices civils de Lyon, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France. · Département de radiothérapie, institut Sainte-Catherine, 250, chemin de Baigne-Pieds, 84918 Avignon cedex 9, France. · Service de cancérologie et radiothérapie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France. ·Cancer Radiother · Pubmed #27516051.

ABSTRACT: The prostate external beam radiotherapy techniques are described, when irradiating the prostate or after prostatectomy, with and without pelvic lymph nodes. The following parts are presented: indications of radiotherapy, total dose and fractionation, planning CT image acquisition, volume of interest delineation (target volumes and organs at risk) and margins, Intensity modulated radiotherapy planning and corresponding dose-volume constraints, and finally Image guided radiotherapy.

18 Guideline Clinical practice guidelines for ultrasound elastography: prostate. 2016

Anonymous1160860. · ·J Med Ultrason (2001) · Pubmed #26926338.

ABSTRACT: -- No abstract --

19 Guideline Trial Design and Objectives for Castration-Resistant Prostate Cancer: Updated Recommendations From the Prostate Cancer Clinical Trials Working Group 3. 2016

Scher, Howard I / Morris, Michael J / Stadler, Walter M / Higano, Celestia / Basch, Ethan / Fizazi, Karim / Antonarakis, Emmanuel S / Beer, Tomasz M / Carducci, Michael A / Chi, Kim N / Corn, Paul G / de Bono, Johann S / Dreicer, Robert / George, Daniel J / Heath, Elisabeth I / Hussain, Maha / Kelly, Wm Kevin / Liu, Glenn / Logothetis, Christopher / Nanus, David / Stein, Mark N / Rathkopf, Dana E / Slovin, Susan F / Ryan, Charles J / Sartor, Oliver / Small, Eric J / Smith, Matthew Raymond / Sternberg, Cora N / Taplin, Mary-Ellen / Wilding, George / Nelson, Peter S / Schwartz, Lawrence H / Halabi, Susan / Kantoff, Philip W / Armstrong, Andrew J / Anonymous3240859. ·Howard I. Scher, Michael J. Morris, Dana E. Rathkopf, and Susan F. Slovin, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College; David Nanus, NewYork Presbyterian Weill Cornell Medical Center; Lawrence W. Schwartz, NewYork Presbyterian Columbia University Medical Center, New York, NY; Walter M. Stadler, University of Chicago Medicine, Chicago, IL; Celestina Higano and Peter S. Nelson, University of Washington and Fred Hutchinson Cancer Research Center, Seattle, WA; Ethan Basch, University of North Carolina at Chapel Hill, Chapel Hill, NC; Emmanual S. Antonarakis and Michael A. Carducci, Johns Hopkins University School of Medicine, Baltimore, MD; Tomasz M. Beer, Oregon Health and Science University, Portland, OR; Paul G. Corn and Christopher Logothetis, MD Anderson Cancer Center, Houston, TX; Robert Dreicer, University of Virginia School of Medicine, Charlottesville, VA; Daniel J. George, Susan Halabi, and Andrew J. Armstrong, Duke University and Duke Cancer Institute, Durham, NC; Elisabeth I. Heath, Wayne State University Karmanos Cancer Institute, Detroit; and Maha Hussain, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Wm. Kevin Kelly, Sidney Kimmel School of Medicine at Thomas Jefferson University, Philadelphia, PA; Glenn Liu and George Wilding, University of Wisconsin Carbone Cancer Center, Madison, WI; Mark N. Stein, The Cancer Institute of New Jersey, Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, New Brunswick, NJ; Charles S. Ryan and Eric J. Small, University of California Helen Diller Family Comprehensive Cancer Center, San Francisco, CA; Oliver Sartor, Tulane School of Medicine, New Orleans, LA; Matthew Raymond Smith, Massachusetts General Hospital Cancer Center and Harvard Medical School; Mary-Ellen Taplin and Philip W. Kantoff, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA; Karim Fizazi, Institut Gustave Roussy, University of Paris Sud, Villejuif, Franc ·J Clin Oncol · Pubmed #26903579.

ABSTRACT: PURPOSE: Evolving treatments, disease phenotypes, and biology, together with a changing drug development environment, have created the need to revise castration-resistant prostate cancer (CRPC) clinical trial recommendations to succeed those from prior Prostate Cancer Clinical Trials Working Groups. METHODS: An international expert committee of prostate cancer clinical investigators (the Prostate Cancer Clinical Trials Working Group 3 [PCWG3]) was reconvened and expanded and met in 2012-2015 to formulate updated criteria on the basis of emerging trial data and validation studies of the Prostate Cancer Clinical Trials Working Group 2 recommendations. RESULTS: PCWG3 recommends that baseline patient assessment include tumor histology, detailed records of prior systemic treatments and responses, and a detailed reporting of disease subtypes based on an anatomic pattern of metastatic spread. New recommendations for trial outcome measures include the time to event end point of symptomatic skeletal events, as well as time to first metastasis and time to progression for trials in the nonmetastatic CRPC state. PCWG3 introduces the concept of no longer clinically benefiting to underscore the distinction between first evidence of progression and the clinical need to terminate or change treatment, and the importance of documenting progression in existing lesions as distinct from the development of new lesions. Serial biologic profiling using tumor samples from biopsies, blood-based diagnostics, and/or imaging is also recommended to gain insight into mechanisms of resistance and to identify predictive biomarkers of sensitivity for use in prospective trials. CONCLUSION: PCWG3 moves drug development closer to unmet needs in clinical practice by focusing on disease manifestations most likely to affect prognosis adversely for therapeutics tested in both nonmetastatic and metastatic CRPC populations. Consultation with regulatory authorities is recommended if a trial is intended to seek support for drug approval.

20 Guideline The Evolving Biology of Castration-Resistant Prostate Cancer: Review of Recommendations From the Prostate Cancer Clinical Trials Working Group 3. 2016

Geethakumari, Praveen Ramakrishnan / Cookson, Michael S / Kelly, William Kevin / Anonymous110859. · ·Oncology (Williston Park) · Pubmed #26888794.

ABSTRACT: In 2008, the Prostate Cancer Clinical Trials Working Group 2 (PCWG2) developed consensus guidelines for clinical trial design and conduct that redefined trial endpoints, with a dual-objective paradigm: to (1) controlling, relieving, or eliminating disease manifestations at the start of treatment; and (2) preventing or delaying further disease manifestations. Clinical and translational research in prostate cancer has expanded our current-day understanding of the mechanisms of its pathogenesis, as well as the different clinicopathologic and molecular subtypes of the disease, and has improved the therapeutic armamentarium for the management of metastatic castration-resistant prostate cancer (CRPC). These new advances led to the development of the updated PCWG3 guidelines in 2015. In this review, we analyze our evolving understanding of the biology of CRPC, acquired resistance mechanisms, and emerging therapeutic targets in light of the updated PCWG3 guidelines. We present a joint perspective from the medical oncology and urologic disciplines on the ongoing efforts to advance clinical trial performance in order to discover new therapies for this fatal disease.

21 Guideline The Memorial Sloan Kettering Cancer Center Recommendations for Prostate Cancer Screening. 2016

Vickers, Andrew J / Eastham, James A / Scardino, Peter T / Lilja, Hans. ·Memorial Sloan Kettering Cancer Center, New York, NY. Electronic address: vickersa@mskcc.org. · Memorial Sloan Kettering Cancer Center, New York, NY. ·Urology · Pubmed #26850815.

ABSTRACT: The Memorial Sloan Kettering Cancer Center (MSKCC) recommendations on prostate cancer screening were developed in response to three limitations of previous screening guidelines: insufficient evidence base, failure to link screening with treatment, and lack of risk stratification. The objective of the recommendations is to provide a schema for prostate cancer screening that maximizes the benefits, in terms of reduction in prostate cancer-specific mortality, and minimizes the harms, in terms of overdiagnosis and overtreatment. We recommend the following schema for men choosing to be screened following informed decision-making: starting at age 45, prostate-specific antigen (PSA) without digital rectal examination. If PSA ≥ 3 ng/mL: consider prostate biopsy; if PSA ≥ 1 but < 3 ng/mL: return for PSA testing every 2-4 years; if PSA < 1 ng/mL: return for PSA testing at 6-10 years. PSA testing should end at age 60 for men with PSA ≤ 1 ng/ mL; at 70, unless a man is very healthy and has a higher than average PSA; at 75 for all men. The decision to biopsy a man with a PSA > 3 ng/mL should be based on a variety of factors including repeat blood draw for confirmatory testing of the PSA level, digital rectal examination results, and workup for benign disease. Additional reflex tests in blood such as a free-to-total PSA ratio, the Prostate Health Index, or 4Kscore, or urinary testing of PCA3, can also be informative in some patients. The best evidence suggests that more restricted indication for prostate biopsy and a more focused approach to pursue screening in men at highest risk of lethal cancer would retain most of the mortality benefits of aggressive screening schema, while importantly reducing harms from overdetection and overtreatment.

22 Guideline Prostate Cancer, Version 1.2016. 2016

Mohler, James L / Armstrong, Andrew J / Bahnson, Robert R / D'Amico, Anthony Victor / Davis, Brian J / Eastham, James A / Enke, Charles A / Farrington, Thomas A / Higano, Celestia S / Horwitz, Eric M / Hurwitz, Michael / Kane, Christopher J / Kawachi, Mark H / Kuettel, Michael / Lee, Richard J / Meeks, Joshua J / Penson, David F / Plimack, Elizabeth R / Pow-Sang, Julio M / Raben, David / Richey, Sylvia / Roach, Mack / Rosenfeld, Stan / Schaeffer, Edward / Skolarus, Ted A / Small, Eric J / Sonpavde, Guru / Srinivas, Sandy / Strope, Seth A / Tward, Jonathan / Shead, Dorothy A / Freedman-Cass, Deborah A. ·From Roswell Park Cancer Institute; Duke Cancer Institute; The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute; Dana-Farber/Brigham and Women's Cancer Center; Mayo Clinic Cancer Center; Memorial Sloan Kettering Cancer Center; Fred & Pamela Buffett Cancer Center; Prostate Health Education Network (PHEN); Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance; Fox Chase Cancer Center; Yale Cancer Center/Smilow Cancer Hospital; UC San Diego Moores Cancer Center; City of Hope Comprehensive Cancer Center; Massachusetts General Hospital Cancer Center; Robert H. Lurie Comprehensive Cancer Center of Northwestern University; Vanderbilt-Ingram Cancer Center; Moffitt Cancer Center; University of Colorado Cancer Center; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center; UCSF Helen Diller Family Comprehensive Cancer Center; University of California San Francisco Patient Services Committee Chair; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; University of Michigan Comprehensive Cancer Center; University of Alabama at Birmingham Comprehensive Cancer Center; Stanford Cancer Institute; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine; Huntsman Cancer Institute at the University of Utah; and National Comprehensive Cancer Network. ·J Natl Compr Canc Netw · Pubmed #26733552.

ABSTRACT: The NCCN Guidelines for Prostate Cancer address staging and risk assessment after an initial diagnosis of prostate cancer and management options for localized, regional, and metastatic disease. Recommendations for disease monitoring, treatment of recurrent disease, and systemic therapy for metastatic castration-recurrent prostate cancer also are included. This article summarizes the NCCN Prostate Cancer Panel's most significant discussions for the 2016 update of the guidelines, which include refinement of risk stratification methods and new options for the treatment of men with high-risk and very-high-risk disease and progressive castration-naïve disease.

23 Guideline The 2014 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma: Definition of Grading Patterns and Proposal for a New Grading System. 2016

Epstein, Jonathan I / Egevad, Lars / Amin, Mahul B / Delahunt, Brett / Srigley, John R / Humphrey, Peter A / Anonymous6100846. ·*Departments of Pathology, Urology, and Oncology, The Johns Hopkins Medical Institutions, Baltimore, MD†Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden‡Department of Pathology & Laboratory Medicine, Cedars-Sinai, Los Angeles, CA§Department of Pathology & Molecular Medicine, Wellington School of Medicine & Health Sciences, University of Otago-Wellington, Wellington South, New Zealand∥Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada¶Department of Pathology, Yale School of Medicine, New Haven, CT. ·Am J Surg Pathol · Pubmed #26492179.

ABSTRACT: In November, 2014, 65 prostate cancer pathology experts, along with 17 clinicians including urologists, radiation oncologists, and medical oncologists from 19 different countries gathered in a consensus conference to update the grading of prostate cancer, last revised in 2005. The major conclusions were: (1) Cribriform glands should be assigned a Gleason pattern 4, regardless of morphology; (2) Glomeruloid glands should be assigned a Gleason pattern 4, regardless of morphology; (3) Grading of mucinous carcinoma of the prostate should be based on its underlying growth pattern rather than grading them all as pattern 4; and (4) Intraductal carcinoma of the prostate without invasive carcinoma should not be assigned a Gleason grade and a comment as to its invariable association with aggressive prostate cancer should be made. Regarding morphologies of Gleason patterns, there was clear consensus on: (1) Gleason pattern 4 includes cribriform, fused, and poorly formed glands; (2) The term hypernephromatoid cancer should not be used; (3) For a diagnosis of Gleason pattern 4, it needs to be seen at 10x lens magnification; (4) Occasional/seemingly poorly formed or fused glands between well-formed glands is insufficient for a diagnosis of pattern 4; (5) In cases with borderline morphology between Gleason pattern 3 and pattern 4 and crush artifacts, the lower grade should be favored; (6) Branched glands are allowed in Gleason pattern 3; (7) Small solid cylinders represent Gleason pattern 5; (8) Solid medium to large nests with rosette-like spaces should be considered to represent Gleason pattern 5; and (9) Presence of unequivocal comedonecrosis, even if focal is indicative of Gleason pattern 5. It was recognized by both pathologists and clinicians that despite the above changes, there were deficiencies with the Gleason system. The Gleason grading system ranges from 2 to 10, yet 6 is the lowest score currently assigned. When patients are told that they have a Gleason score 6 out of 10, it implies that their prognosis is intermediate and contributes to their fear of having a more aggressive cancer. Also, in the literature and for therapeutic purposes, various scores have been incorrectly grouped together with the assumption that they have a similar prognosis. For example, many classification systems consider Gleason score 7 as a single score without distinguishing 3+4 versus 4+3, despite studies showing significantly worse prognosis for the latter. The basis for a new grading system was proposed in 2013 by one of the authors (J.I.E.) based on data from Johns Hopkins Hospital resulting in 5 prognostically distinct Grade Groups. This new system was validated in a multi-institutional study of over 20,000 radical prostatectomy specimens, over 16,000 needle biopsy specimens, and over 5,000 biopsies followed by radiation therapy. There was broad (90%) consensus for the adoption of this new prostate cancer Grading system in the 2014 consensus conference based on: (1) the new classification provided more accurate stratification of tumors than the current system; (2) the classification simplified the number of grading categories from Gleason scores 2 to 10, with even more permutations based on different pattern combinations, to Grade Groups 1 to 5; (3) the lowest grade is 1 not 6 as in Gleason, with the potential to reduce overtreatment of indolent cancer; and (4) the current modified Gleason grading, which forms the basis for the new grade groups, bears little resemblance to the original Gleason system. The new grades would, for the foreseeable future, be used in conjunction with the Gleason system [ie. Gleason score 3+3=6 (Grade Group 1)]. The new grading system and the terminology Grade Groups 1-5 have also been accepted by the World Health Organization for the 2016 edition of Pathology and Genetics: Tumours of the Urinary System and Male Genital Organs.

24 Guideline Singapore Cancer Network (SCAN) Guidelines for the Management of Advanced Castrate-Resistant Prostate Cancer. 2015

Anonymous840855. · ·Ann Acad Med Singapore · Pubmed #26763057.

ABSTRACT: INTRODUCTION: The SCAN genitourinary cancer workgroup aimed to develop Singapore Cancer Network (SCAN) clinical practice guidelines for the management of advanced castrate-resistant prostate cancer. MATERIALS AND METHODS: The workgroup utilised a modified ADAPTE process to calibrate high quality international evidence-based clinical practice guidelines to our local setting. RESULTS: Five international guidelines were evaluated- those developed by the National Comprehensive Cancer Network (2014), the European Society of Medical Oncology (2013), the American Urological Association (2013), the National Institute of Health and Clinical Excellence (2014) and the American Society of Clinical Oncology and Cancer Care Ontario (2014). Recommendations on the management of advanced castrate-resistant prostate cancer were developed. CONCLUSION: These adapted guidelines form the SCAN Guidelines 2015 for the management of advanced castrate-resistant prostate cancer.

25 Guideline NCCN Clinical Practice Guidelines Prostate Cancer Early Detection, Version 2.2015. 2015

Carroll, Peter R / Parsons, J Kellogg / Andriole, Gerald / Bahnson, Robert R / Barocas, Daniel A / Castle, Erik P / Catalona, William J / Dahl, Douglas M / Davis, John W / Epstein, Jonathan I / Etzioni, Ruth B / Farrington, Thomas / Hemstreet, George P / Kawachi, Mark H / Lange, Paul H / Loughlin, Kevin R / Lowrance, William / Maroni, Paul / Mohler, James / Morgan, Todd M / Nadler, Robert B / Poch, Michael / Scales, Chuck / Shaneyfelt, Terrence M / Smaldone, Marc C / Sonn, Geoffrey / Sprenke, Preston / Vickers, Andrew J / Wake, Robert / Shead, Dorothy A / Freedman-Cass, Deborah. · ·J Natl Compr Canc Netw · Pubmed #26656522.

ABSTRACT: Prostate cancer represents a spectrum of disease that ranges from nonaggressive, slow-growing disease that may not require treatment to aggressive, fast-growing disease that does. The NCCN Guidelines for Prostate Cancer Early Detection provide a set of sequential recommendations detailing a screening and evaluation strategy for maximizing the detection of prostate cancer that is potentially curable and that, if left undetected, represents a risk to the patient. The guidelines were developed for healthy men who have elected to participate in the early detection of prostate cancer, and they focus on minimizing unnecessary procedures and limiting the detection of indolent disease.

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