Prostate Cancer

Full Text Guidelines Summary of Changes Scientific Publications & Appendices Pocket Guidelines Archive Panel

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N. Mottet (Chair), R.C.N. van den Bergh, E. Briers (Patient Representative), L. Bourke, P. Cornford (Vice-chair), M. De Santis, S. Gillessen, A. Govorov, J. Grummet, A.M. Henry, T.B. Lam, M.D. Mason, H.G. van der Poel, T.H. van der Kwast, O. Rouvière, T. Wiegel
Guidelines Associates: T. Van den Broeck, M. Cumberbatch, N. Fossati, T. Gross, M. Lardas, M. Liew, L. Moris, I.G. Schoots, P.M. Willemse

1.INTRODUCTION

1.1.Aims and scope

The Prostate Cancer (PCa) Guidelines Panel have prepared this guidelines document to assist medical professionals in the evidence-based management of PCa.

It must be emphasised that clinical guidelines present the best evidence available to the experts but following guideline recommendations will not necessarily result in the best outcome. Guidelines can never replace clinical expertise when making treatment decisions for individual patients, but rather help to focus decisions - also taking personal values and preferences/individual circumstances of patients into account.

Guidelines are not mandates and do not purport to be a legal standard of care.

1.2.Panel composition

The PCa Guidelines Panel consists of an international multidisciplinary group of urologists, radiation oncologists, medical oncologists, radiologists, a pathologist and a patient representative.

All imaging sections in the text have been developed, jointly with the European Society of Urogenital Radiology (ESUR). Representatives of ESUR in the PCa Guidelines Panel are (in alphabetical order): Prof.Dr. O Rouvière and Dr. I.G. Schoots.

Section 6.3: Treatment - Definitive Radiotherapy, has been developed jointly with the European Society for Radiotherapy & Oncology (ESTRO). Representatives of ESTRO in the PCa Guidelines Panel are (in alphabetical order): Prof.Dr. A.M. Henry, Prof.Dr. M.D. Mason and Prof.Dr. T. Wiegel.

All experts involved in the production of this document have submitted potential conflict of interest statements which can be viewed on the EAU website Uroweb: http://uroweb.org/guideline/prostate-cancer/.

1.2.1.Acknowledgement

The PCa Guidelines Panel are most grateful for the support and considerable expertise provided by Prof.Dr. J-P. Droz, Emeritus Professor of Medical Oncology (Lyon, France) on the topic of ‘Evaluating health status and life expectancy’. As a leading expert in this field and prominent member of the International Society of Geriatric Oncology, his contribution has been invaluable.

1.3.Available publications

A quick reference document (Pocket guidelines) is available, both in print and as an app for iOS and Android devices. These are abridged versions which may require consultation together with the full text version. Several scientific publications are available [1,2] as are a number of translations of all versions of the PCa Guidelines. All documents can be accessed on the EAU website: http://uroweb.org/guideline/prostate-cancer/.

1.4.Publication history and summary of changes

1.4.1.Publication history

The EAU PCa Guidelines were first published in 2001. This 2018 document presents a full update of the 2017 full text document.

1.4.2.Summary of changes

New and relevant evidence has been identified, collated and appraised through a structured assessment of the literature and incorporated in all chapters of the 2018 EAU PCa Guidelines.

Key changes for the 2018 print:

The literature for the complete document has been assessed and updated, where relevant. The treatment sections have been completely restructured and evidence summaries and recommendations have been amended throughout the current document.

Several new sections have been added:

  • Section 5.3.3.2 - Fluoride PET and PET/CT, choline PET/CT and MRI
  • Section 5.3.3.3 - Prostate-specific membrane antigen-based PET/CT
  • Section 5.3.3.4 - Summary of evidence and practical consideration regarding initial N/M staging

Specific sections of the text have been updated based on systematic review (SR) questions prioritised by the Guidelines Panel. These reviews were performed using standard Cochrane SR methodology; http://www.cochranelibrary.com/about/about-cochrane-systematic-reviews.html:


  • Section 5.2.4.2 - Multiparametric magnetic resonance imaging (mpMRI) and Section 6.2.1.1.3 – Imaging for treatment selection [3].
  • Section - 6.1.2.1.1 Pelvic lymph node dissection and Section 6.1.2.3.1 - Early complications of extended lymph node dissection [4].