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Abstract
To present a summary of the 2007 version of the European Association of Urology (EAU)
guidelines on prostate cancer (PCa).
A literature review of the new data emerging from 2004 to 2007 was performed by the
working panel. The guidelines have been updated, and the level of evidence/grade of
recommendation was added to the text based on a systematic review of the literature,
which included a search of online databases and bibliographic reviews.
A full version is available at the EAU Office or at www.uroweb.org. Systemic prostate
biopsy under ultrasound guidance is the preferred diagnostic method. Active treatment
is mostly recommended for patients with localized disease and a long life expectancy,
with radical prostatectomy being shown to be superior to watchful waiting in a prospective
randomized trial. Nerve-sparing radical prostatectomy represents the approach of choice
in organ-confined disease; neoadjuvant androgen deprivation demonstrates no improvement
of outcome variables. Radiation therapy should be performed with at least 72 and 78
Gy in low-risk and intermediate- to high-risk PCa, respectively. Monotherapeutic androgen
deprivation is the standard of care in metastatic PCa; intermittent androgen deprivation
might be an alternative treatment option for selected patients. Follow-up is largely
based on prostate-specific antigen and a disease-specific history with imaging only
indicated when symptoms occur. Cytotoxic therapy with docetaxel has emerged as the
reference treatment for metastatic hormone-refractory PCa.
The knowledge in the field of PCa is rapidly changing. These EAU guidelines on PCa
summarize the most recent findings and put them into clinical practice.