%0 Journal Article
%T The Swedish national guidelines on prostate cancer, part 2: recurrent, metastatic and castration resistant disease.
%A Bratt O
%A Carlsson S
%A Fransson P
%A Kindblom J
%A Stranne J
%A Karlsson CT
%A
%J Scand J Urol
%V 56
%N 4
%D Aug 2022
%M 35798533
%F 1.899
%R 10.1080/21681805.2022.2093396
%X UNASSIGNED: There is now an unprecedented amount of evidence to consider when revising prostate cancer guidelines. We believe that there is a value in publishing summaries of national clinical guidelines in English for others to read and comment on.
UNASSIGNED: This is part 2 of a summary of the Swedish prostate cancer guidelines that were published in June 2022. This part covers recurrence after local treatment and management of metastatic and castration resistant disease. Part 1 covers early detection, diagnostics, staging, patient support and management of non-metastatic disease.
UNASSIGNED: The 2022 Swedish guidelines include several new recommendations. Among these is a recommendation of a period of observation with repeated PSA tests for patients with approximately 10 years' life expectancy who experience a BCR more than 2-5 years after radical prostatectomy, to allow for estimating the PSA doubling time before deciding whether to give salvage radiotherapy or not. Recent results from the PEACE-1 trial led to the recommendation of triple-treatment with a GnRH agonist, abiraterone plus prednisolone and 6 cycles of docetaxel for patients with high-volume metastatic disease who are fit for chemotherapy. The Swedish guidelines differ from the European ones by having more restrictive recommendations about genetic testing of and high-dose zoledronic acid or denosumab treatment for men with metastatic prostate cancer, and by recommending considering bicalutamide monotherapy for selected patients with low-volume metastatic disease.
UNASSIGNED: The 2022 Swedish prostate cancer guidelines include several new recommendations and some that differ from the European guidelines.