EAU-EANM-ESTRO-ESUR-SIOG Guidelines on Prostate Cancer. Part II-2020 Update: Treatment of Relapsing and Metastatic Prostate Cancer.

To present a summary of the 2020 version of the European Association of Urology (EAU)-European Association of Nuclear Medicine (EANM)-European Society for Radiotherapy & Oncology (ESTRO)-European Society of Urogenital Radiology (ESUR)-International Society of Geriatric Oncology (SIOG) guidelines on the treatment of relapsing, metastatic, and castration-resistant prostate cancer (CRPC).

The working panel performed a literature review of the new data (2016-2019). The guidelines were updated, and the levels of evidence and/or grades of recommendation were added based on a systematic review of the literature.

Prostate-specific membrane antigen positron emission tomography computed tomography scanning has developed an increasingly important role in men with biochemical recurrence after local therapy. Early salvage radiotherapy after radical prostatectomy appears as effective as adjuvant radiotherapy and, in a subset of patients, should be combined with androgen deprivation. New treatments have become available for men with metastatic hormone-sensitive prostate cancer (PCa), nonmetastatic CRPC, and metastatic CRPC, along with a role for local radiotherapy in men with low-volume metastatic hormone-sensitive PCa. Also included is information on quality of life outcomes in men with PCa.

The knowledge in the field of advanced and metastatic PCa and CRPC is changing rapidly. The 2020 EAU-EANM-ESTRO-ESUR-SIOG guidelines on PCa summarise the most recent findings and advice for use in clinical practice. These PCa guidelines are first endorsed by the EANM and reflect the multidisciplinary nature of PCa management. A full version is available from the EAU office or online (http://uroweb.org/guideline/prostate-cancer/).

This article summarises the guidelines for the treatment of relapsing, metastatic, and castration-resistant prostate cancer. These guidelines are evidence based and guide the clinician in the discussion with the patient on the treatment decisions to be taken. These guidelines are updated every year; this summary spans the 2017-2020 period of new evidence.

European urology. 2020 Oct 07 [Epub ahead of print]

Philip Cornford, Roderick C N van den Bergh, Erik Briers, Thomas Van den Broeck, Marcus G Cumberbatch, Maria De Santis, Stefano Fanti, Nicola Fossati, Giorgio Gandaglia, Silke Gillessen, Nikolaos Grivas, Jeremy Grummet, Ann M Henry, Theodorus H van der Kwast, Thomas B Lam, Michael Lardas, Matthew Liew, Malcolm D Mason, Lisa Moris, Daniela E Oprea-Lager, Henk G van der Poel, Olivier Rouvière, Ivo G Schoots, Derya Tilki, Thomas Wiegel, Peter-Paul M Willemse, Nicolas Mottet

Department of Urology, Liverpool University Hospitals NHS Trust, Liverpool, UK. Electronic address: ., Department of Urology, St. Antonius Hospital, Utrecht, The Netherlands., Hasselt, Belgium., Department of Urology, University Hospitals Leuven, Leuven, Belgium., Academic Urology Unit, University of Sheffield, Sheffield, UK., Department of Urology, Charité Universitätsmedizin, Berlin, Germany; Department of Urology, Medical University of Vienna, Vienna, Austria., Department of Nuclear Medicine, Policlinico S. Orsola, University of Bologna, Italy., Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy., Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Università della Svizzera Italiana, Lugano, Switzerland; University of Bern, Bern, Switzerland; Division of Cancer Sciences, University of Manchester, Manchester, UK., Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands., Department of Surgery, Central Clinical School, Monash University, Caulfield North, Victoria, Australia., Leeds Cancer Centre, St. James's University Hospital and University of Leeds, Leeds, UK., Department of Pathology, Erasmus University Medical Center, Rotterdam, The Netherlands., Academic Urology Unit, University of Aberdeen, Aberdeen, UK; Department of Urology, Aberdeen Royal Infirmary, Aberdeen, UK., Department of Urology, Metropolitan General Hospital, Athens, Greece., Department of Urology, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK., Division of Cancer & Genetics, School of Medicine Cardiff University, Velindre Cancer Centre, Cardiff, UK., Department of Urology, University Hospitals Leuven, Leuven, Belgium; Laboratory of Molecular Endocrinology, KU Leuven, Leuven, Belgium., Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands., Hospices Civils de Lyon, Department of Urinary and Vascular Imaging, Hôpital Edouard Herriot, Lyon, France; Faculté de Médecine Lyon Est, Université de Lyon, Université Lyon 1, Lyon, France., Department of Radiology & Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Radiology, Netherlands Cancer Institute, Amsterdam, The Netherlands., Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany., Department of Radiation Oncology, University Hospital Ulm, Ulm, Germany., Department of Urology, Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands., Department of Urology, University Hospital, St. Etienne, France.