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

Boston, MA ( Dr. Taplin spoke on the 2017 AUA guidelines for high-risk prostate cancer. The panel defined high-risk prostate cancer has Gleason grade group 4-5 (former Gleason sum 8-0), or PSA> 20, and stage T1-2. Further, the panel did not stratify patients into high risk and very high risk like the NCCN has done.

The recommendation statements are as follows:

  • All patients should have cross sectional imaging (CT scan or MRI) and bone scan
  • The standard therapy is radical prostatectomy OR radiation therapy with androgen deprivation therapy
  • Watchful waiting should only be considered in asymptomatic men with short life expectancies
  • Primary ADT should only be offered in symptomatic men with short life expectancy
  • Active surveillance is not recommended
  • Focal therapies including HIFU and cryoablation are not recommended
  • Clinicians should consider referral to genetic counseling for patients and their families with the combination of high-risk localized prostate cancer and a strong family history of specific cancers (breast, ovarian, pancreas, GI tumors, lymphoma)
  • Future directions include randomized trials to inform the proper role of focal ablative technology, new imaging modalities, and digital tools to facilitate shared decision-making

A complete summary of the new AUA localized prostate cancer guidelines can be found:

Presented By: Mary Taplin, MD, Dana Farber Cancer Institute, Boston, MA

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

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