Prostate cancer

Treatment of low and intermediate-risk PCa

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Educational Objective: Gain insight into the treatment choices for men with low- and intermediate-risk PCa, with a focus on radical treatments.
Specialty: Urology, Radiation oncology
Target Audience: CME (basic), Residents (senior)
Latest update: January 2022
Background:

Men with PSA-detected clinically localised PCa have excellent 10-year survival rates irrespective of the treatment (ProtecT trial). Is treatment choice here just a matter of patient preference? This topic focusses on clinical characteristics that impact treatment choice, including life expectancy and risk of (biochemical) recurrence.

The EAU and NCCN guidelines stratify patients with PCa into risk groups to facilitate treatment recommendations [1,2].

PCa risk stratification according to the EAU and NCCN guidelines

  1. Mottet N, Cornford P, van den Bergh RCN, et al. EAU – EANM – ESTRO – ESUR – ISUP – SIOG guidelines on prostate cancer. Update 2021. Available at: http://uroweb.org/guideline/prostate-cancer/
  2. Schaeffer E, Srinivas S, Antonarakis ES, et al. National Comprehensive Cancer Network (NCCN) clinical practice guidelines in oncology: Prostate cancer. Version 2.2022. Available at: https://www.nccn.org/guidelines/category_1