The European Association of Urology (EAU) Guidelines Group for Prostate Cancer have prepared this guidelines document to assist medical professionals assess the evidence-based management of prostate cancer. The multidisciplinary panel of experts include urologists, radiation oncologists, a medical oncologist, and a pathologist. Where possible a level of evidence (LE) and/or grade of recommendation (GR) have been assigned (1). Recommendations are graded in order to provide transparency between the underlying evidence and the recommendation given (Tables 1 and 2). | Guidelines on Prostate Cancer A. Heidenreich chairman M. Bolla S. Joniau . Mason V. Matveev N. Mottet H-P. Schmid . van der Kwast T. Wiegel F. Zattoni European Association of Urology 2011 European Association of Urology TABLE OF CONTENTS PAGE 1. INTRODUCTION 7 7 7 8 Methodology Publication history References 2. BACKGROUND 8 References 8 3. CLASSIFICATION 9 Gleason score 10 References 10 4. RISK FACTORS 10 References 10 5. SCREENING AND EARLY DETECTION 11 References 12 6. DIAGNOSIS 13 Digital rectal examination DRE 13 Prostate-specific antigen PSA 13 Free total PSA ratio f t PSA 14 PSA velocity PSAV PSA doubling time PSADT 14 PCA3 marker 14 Transrectal ultrasonography TRUS 14 Prostate biopsy 15 Baseline biopsy 15 Repeat biopsy 15 Saturation biopsy 15 Sampling sites and number of cores 15 Diagnostic transurethral resection of the prostate TURP 15 Seminal vesicle biopsy 15 Transition zone biopsy 15 Antibiotics 16 Local anaesthesia 16 Fine-needle aspiration biopsy 16 Complications 16 Pathology of prostate needle biopsies 16 Grossing and processing 16 Microscopy and reporting 16 Pathohistology of radical prostatectomy RP specimens 17 Processing of the RP specimen 17 Recommendations for processing a prostatectomy specimen 18 RP specimen report 18 Gleason score 19 Interpreting the Gleason score 19 Definition of extraprostatic extension 19 Prostate cancer volume 19 Surgical margin status 19 Other factors 20 References 20 7. STAGING 25 T-staging 25 N-staging 26 M-staging 27 Guidelines for the diagnosis and staging of PCa 28 References 29 2 UPDATE JANUARY 2011 8. TREATMENT DEFERRED TREATMENT WATCHFUL WAITING ACTIVE MONITORING 33 Introduction 33 Definition 33 Watchful waiting WW 34 Active surveillance AS 34 .
