Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- elevated prostate-specific antigen (PSA)
Outros fatores diagnósticos
- abnormal digital rectal exam (DRE)
- nocturia
- urinary frequency
- urinary hesitancy
- dysuria
- hematuria
- weight loss/anorexia
- lethargy
- bone pain
- palpable lymph nodes
Fatores de risco
- age >50 years
- black ethnicity
- Northwest European, Caribbean, Australian, New Zealand, North American, and Southern African populations
- positive family history/genetic factors
- high levels of dietary fat
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- serum prostate-specific antigen (PSA)
- prebiopsy multiparametric MRI
- prostate biopsy
Investigações a serem consideradas
- prebiopsy biomarker testing
- testosterone
- LFTs
- CBC
- renal function
- bone scan (technetium-99)
- CT scan
- MRI
- prostate-specific membrane antigen (PSMA)-PET/CT
- PSMA-PET/MRI
- genetic and molecular testing
Algoritmo de tratamento
very low-risk disease
low-risk disease
favorable intermediate-risk disease
unfavorable intermediate-risk disease
high-risk or very high-risk disease
nonmetastatic disease: postradical prostatectomy
nonmetastatic disease: postexternal beam radiation therapy
nonmetastatic disease: castration-resistant
metastatic disease: castration-sensitive
metastatic disease: castration-resistant
Colaboradores
Autores
Timothy J. Wallace, MD, PhD
Radiation Oncologist
Department of Radiation Oncology
Virginia Commonwealth University
Richmond
VA
Declarações
TJW declares that he has no competing interests.
Mitchell S. Anscher, MD, FACR, FACRO, FASTRO
Professor Emeritus
Department of Radiation Oncology
Virginia Commonwealth University
Richmond
VA
Declarações
MSA declares that he has no competing interests.
Revisores
Emma Alexander, MBBS
Clinical Oncology Registrar
St Luke's Cancer Centre
Royal Surrey Hospital
Guildford
Surrey
UK
Declarações
EA has received consultation fees from the following organizations: Blue Cross/Blue Shield Association, Sanofi-Aventis, Ferring Pharmaceuticals, Pfizer Corporation, American Urological Association, National Institutes of Health, Accreditation Council for Graduate Medical Education, Royal Hallamshire Hospital, Hartford County Medical Association. EA owns shares in Pfizer Pharmaceuticals, Johnson and Johnson, and General Electric Corporation.
Peter Albertsen, MD
Medical Director
UConn Medical Group
University of Connecticut Health Center
Farmington
CT
Declarações
PA declares that he has no competing interests.
Patrick C. Walsh, MD
University Distinguished Service Professor of Urology
Professor Emeritus of Urology
Brady Urological Institute
Johns Hopkins University
Baltimore
MD
Declarações
PCW declares that he has no competing interests.
James Kearns, MD
Assistant Professor of Urology
NorthShore University HealthSystem
Chicago
IL
Declarações
JK declares that he has no competing interests. JK is an author of an article cited in the topic.
Referências
Principais artigos
National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: prostate cancer [internet publication].Texto completo
National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: prostate cancer early detection [internet publication].Texto completo
Parker C, Castro E, Fizazi K, et al. Prostate cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2020 Sep;31(9):1119-34.Texto completo Resumo
Morgan SC, Hoffman K, Loblaw DA, et al. Hypofractionated radiation therapy for localized prostate cancer: an ASTRO, ASCO, and AUA evidence-based guideline. J Clin Oncol. 2018 Oct 11;36(34):JCO1801097.Texto completo Resumo
Morgan TM, Boorjian SA, Buyyounouski MK, et al. Salvage therapy for prostate cancer: AUA/ASTRO/SUO guideline part I: introduction and treatment decision-mMaking at the time of suspected biochemical recurrence after radical prostatectomy. J Urol. 2024 Apr;211(4):509-17.Texto completo Resumo
Morgan TM, Boorjian SA, Buyyounouski MK, et al. Salvage therapy for prostate cancer: AUA/ASTRO/SUO guideline part II: treatment delivery for non-metastatic biochemical recurrence after primary radical prostatectomy. J Urol. 2024 Apr;211(4):518-25.Texto completo Resumo
Morgan TM, Boorjian SA, Buyyounouski MK, et al. Salvage therapy for prostate cancer: AUA/ASTRO/SUO guideline part III: salvage therapy after radiotherapy or focal therapy, pelvic nodal recurrence and oligometastasis, and future directions. J Urol. 2024 Apr;211(4):526-32.Texto completo Resumo
Artigos de referência
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Diagnósticos diferenciais
- Benign prostatic hyperplasia
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