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AUA 2017

AUA 2017: AUA Guidelines 2017 – localized, low risk prostate cancer

Boston, MA (UroToday.com) Dr. Cadeddu presented the 2017 AUA guidelines on the management of very low and low risk prostate cancer. The guidelines are based on a systematic review performed by the Agency of Healthcare and Research Quality from 207-2014. This was supplemented using 2015-2016 data. A great emphasis is placed on shared decision-making. Both very low risk and low risk are defined by Gleason group 1 (former 3+3=6) cancers with PSA < 10ng/dL. Very low risk is further defined as 1 or fewer cores with 50% or less cancer per core and PSA density < 0.15.

The recommendation statements are as follows:
• Bone scan should not be employed in low risk prostate cancer patients
• Active surveillance is best available care for very low risk prostate cancer
• Active surveillance is preferred for low risk prostate cancer
  •  Clinicians may offer definitive treatment to select patients who may have high probability of progression
• If treatment is offered, no androgen deprivation therapy should be used except to reduce prostate size for the purposes of brachytherapy
• While gland cryotherapy is not recommended as the side effects are considerable and no survival benefit has been demonstrated
• Focal therapy is not standard of care and comparative survival evidence is lacking
• Clinicians should recommend watchful waiting or observation (distinct from active surveillance) for men with a life expectancy less than 5 years.
• Among men with low risk prostate cancer, tissue-based biomarkers have not been shown to have a clear role in selection of candidates for active surveillance.

The full guidelines can be found at http://www.auanet.org/guidelines/clinically-localized-prostate-cancer-new-(aua/astro/suo-guideline-2017)

Presented By: Jeffrey Cadeddu, MD, University of Texas – Southwestern, Dallas, TX

Written By: Benjamin T. Ristau, MD, Fox Chase Cancer Center, Philadelphia, PA

at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA