Contents

1.Overview

2. Risk factors of prostate cancer

2.1 Age and genetic factors

2.2 Exogenous factors

3. Pathological classification and grading system

4. Diagnostic evaluation

4.1 Monitoring and screening for population with high-risk prostate cancer

4.2 Genetic testing

4.3 Digital rectal examination (DRE)

4.4 Magnetic resonance examination

4.5 Bone scan examination

4.6 Positron emission tomography-computed tomography (PET-CT)

4.7 Prostate biopsy

4.7.1 Indication and contraindication for systemic prostate biopsy

4.7.2 Implementation of prostate biopsy

4.7.3 Repeated systemic prostate biopsy

4.7.4 Limitations and new strategies for prostate systemic biopsies

5. Treatment of prostate cancer

5.1 Treatment for localized prostate cancer

5.1.1 Watchful waiting and active surveillance

5.1.2 Radical prostatectomy

5.1.3 Radical treatment for low-risk prostate cancer

5.1.4 Radical treatment for intermediate-risk prostate cancer

5.1.5 Radical treatment for high-risk prostate cancer

5.1.6 PLND

5.1.7 Indications for nerve-sparring radical prostatectomy

5.1.8 Adjuvant treatment after radical prostatectomy

5.1.9 Surgical treatment for biochemical recurrence after radiotherapy

6. Radiotherapy for prostate cancer

6.1 External beam radiotherapy (EBRT)

6.1.1 Indications of EBRT for prostate cancer

6.1.2 Complications of EBRT for prostate cancer

6.1.3 Adjuvant radiotherapy after radical prostatectomy

6.1.4 Radiotherapy for distant metastasis

6.2 Brachytherapy for prostate cancer

6.3 Proton therapy

7. Other treatments for localized prostate cancer

8. ADT

8.1 Regimens of ADT

8.1.1 Intermittent and continuous ADT

8.1.2 Combination of ADT and chemotherapy

8.2 ADT regimen strategy based on risk group of prostate cancer

8.2.1 ADT for low-risk prostate cancer patients

8.2.2 ADT for intermediate-risk prostate cancer

8.2.3 ADT for high-risk prostate cancer

8.2.4 ADT for very high-risk prostate cancer

8.3 ADT for pelvic lymph node metastasis and metastatic prostate cancer

8.4 Treatment of primary lesions under ADT treatment

8.5 ADT for biochemical recurrence of patients treated with radical prostatectomy

8.6 Complications of ADT

8.6.1 Adverse effects of conventional ADT

8.6.2 Bone health in ADT

8.6.3 ADT and diabetes and cardiovascular disease

9. Treatment of castration-resistant prostate cancer (CRPC)

9.1 Definition of CRPC

9.2 Asymptomatic non-metastatic CPPC (M0CRPC)

9.3 Metastatic CRPC (mCRPC)

9.3.1 Role of castration therapy in patients with mCRPC

9.3.2 First-line medical treatment for mCRPC

9.4 Other new medicines for mCRPC

      9.5 Treatment of SREs for patients with mCRPC

Prostate cancer is the second most common cause of cancer in males worldwide, and it is the second leading cause of cancer death in American males behind lung cancer. According to data from China National Cancer Registration Institute, prostate cancer has become the most common tumor in male urinary malignancies since 2008. The incidence rate is about 9.80/100,000 in 2014 and ranks the sixth common malignancy in male malignant tumors. The mortality of prostate cancer is 4.22/100,000, and it is the 9th common cause of death in all male malignancies. It is important to note that the incidence of prostate cancer in China varies widely between urban and rural areas, with especially high incidence in large cities. The prevalence in urban and rural areas is 13.57/100,000 and 5.35/100,000, respectively in 2014. With population over 65 years old accounting for more than 10% of the total population in Shanghai, it could be expected that the incidence of prostate cancer would increase dramatically. In addition, the staging varies widely between China and Western developed countries. In China, only 30% of newly diagnosed patients are clinically localized, and the rest are locally advanced or extensively metastatic disease, who have lost the chance of radical treatment with poor prognosis.

原文阅读

PDF下载

@Script