radical prostatectomy

前列腺癌根治术
  • 文章类型: Journal Article
    在2023年,美国泌尿外科协会(AUA)要求进行更新文献综述(ULR),以纳入自本指南2019年发布以来产生的新证据。由此产生的2024年指南修正案提出了更新的建议,为前列腺治疗(IPT)后尿失禁患者的护理提供指导。
    2023年,IPT指南通过AUA修订过程进行了更新,在该过程中,对新发布的文献进行了审查,并将其整合到先前发布的指南中。最初在初步摘要综述中确定了82项感兴趣的研究。在全文审查之后,17项研究符合纳入标准,并最终告知了感兴趣的陈述。
    专家小组根据最新的综述制定了基于证据和共识的声明,为经历IPT的患者的护理提供指导。这些更新在这里详细介绍。
    随着前列腺治疗的完善,预计失禁的发生率会下降。随着IPT患者的诊断和治疗方案的不断发展,本指南将需要进一步审查。
    UNASSIGNED: In 2023 the American Urological Association (AUA) requested an Update Literature Review (ULR) to incorporate new evidence generated since the 2019 publication of this Guideline. The resulting 2024 Guideline Amendment addresses updated recommendations to provide guidance for the care of patients with incontinence after prostate treatment (IPT).
    UNASSIGNED: In 2023, the IPT Guideline was updated through the AUA amendment process in which newly published literature is reviewed and integrated into previously published guidelines. There were 82 studies of interest initially identified in preliminary abstract review. Following full-text review, 17 studies met inclusion criteria and ultimately informed the statements of interest.
    UNASSIGNED: The Panel developed evidence- and consensus-based statements based on an updated review to provide guidance for the care of patients who experience IPT. These updates are detailed herein.
    UNASSIGNED: As prostate treatments are refined, a decreasing incidence of incontinence is anticipated. This Guideline will require further review as the diagnostic and treatment options for patients with IPT continue to evolve.
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  • 文章类型: Journal Article
    目的:欧洲泌尿外科协会(EAU)-欧洲核医学协会(EANM)-欧洲放射治疗和肿瘤学会(ESTRO)-欧洲泌尿生殖放射学学会(ESUR)-国际泌尿病理学学会(ISUP)-国际老年肿瘤学会(SIOG)指南为临床上局部前列腺癌(PCa)的管理提供了建议。本文旨在介绍EAU-EANM-ESTRO-ESUR-ISUP-SIOG筛查指南的2024版摘要,诊断,和临床局部PCa的治疗。
    方法:小组对所有以英文发布的新数据进行了文献综述,涵盖2020年5月至2023年的时间框架。准则更新了,并根据对证据的系统评价,为每项建议添加强度评级.
    建议一种风险适应策略,用于识别可能患有PCa的男性,通常从50岁开始,基于个性化的预期寿命。建议使用多参数磁共振成像以避免不必要的活检。当考虑活检时,应联合进行靶向性和区域性活检.前列腺特异性膜抗原正电子发射断层扫描成像是识别转移扩散的最敏感技术。主动监测是对低风险PCa男性的适当管理,以及国际泌尿外科病理学学会第2级病变的选定中危患者。解决了当地的治疗方法,以及手术后持久性前列腺特异性抗原的管理。建议在中等风险患者中考虑低分割。应该为患有cN1PCa的患者提供局部治疗,并长期加强激素治疗。
    结论:诊断领域的证据,分期,局部PCa的治疗正在迅速发展。这些PCa指南反映了PCa管理的多学科性质。
    结果:本文是“可治愈”前列腺癌指南的摘要。前列腺癌是通过多步基于风险的筛查过程“发现”的。我们的目标是找到尽可能多的男性可以治愈的癌症。前列腺癌是可以治愈的,如果它位于前列腺;然后它被分类为低,中介-,和高风险的局部和局部晚期前列腺癌。这些风险等级是治疗的基础。低危前列腺癌接受“积极监测”治疗,预后良好的治疗方法。对于低中介风险的主动监督也应作为一种选择进行讨论。在其他情况下,积极治疗,手术,或放射治疗应与潜在的副作用一起讨论,以允许共同决策。
    OBJECTIVE: The European Association of Urology (EAU)-European Association of Nuclear Medicine (EANM)-European Society for Radiotherapy and Oncology (ESTRO)-European Society of Urogenital Radiology (ESUR)-International Society of Urological Pathology (ISUP)-International Society of Geriatric Oncology (SIOG) guidelines provide recommendations for the management of clinically localised prostate cancer (PCa). This paper aims to present a summary of the 2024 version of the EAU-EANM-ESTRO-ESUR-ISUP-SIOG guidelines on the screening, diagnosis, and treatment of clinically localised PCa.
    METHODS: The panel performed a literature review of all new data published in English, covering the time frame between May 2020 and 2023. The guidelines were updated, and a strength rating for each recommendation was added based on a systematic review of the evidence.
    UNASSIGNED: A risk-adapted strategy for identifying men who may develop PCa is advised, generally commencing at 50 yr of age and based on individualised life expectancy. The use of multiparametric magnetic resonance imaging in order to avoid unnecessary biopsies is recommended. When a biopsy is considered, a combination of targeted and regional biopsies should be performed. Prostate-specific membrane antigen positron emission tomography imaging is the most sensitive technique for identifying metastatic spread. Active surveillance is the appropriate management for men with low-risk PCa, as well as for selected favourable intermediate-risk patients with International Society of Urological Pathology grade group 2 lesions. Local therapies are addressed, as well as the management of persistent prostate-specific antigen after surgery. A recommendation to consider hypofractionation in intermediate-risk patients is provided. Patients with cN1 PCa should be offered a local treatment combined with long-term intensified hormonal treatment.
    CONCLUSIONS: The evidence in the field of diagnosis, staging, and treatment of localised PCa is evolving rapidly. These PCa guidelines reflect the multidisciplinary nature of PCa management.
    RESULTS: This article is the summary of the guidelines for \"curable\" prostate cancer. Prostate cancer is \"found\" through a multistep risk-based screening process. The objective is to find as many men as possible with a curable cancer. Prostate cancer is curable if it resides in the prostate; it is then classified into low-, intermediary-, and high-risk localised and locally advanced prostate cancer. These risk classes are the basis of the treatments. Low-risk prostate cancer is treated with \"active surveillance\", a treatment with excellent prognosis. For low-intermediary-risk active surveillance should also be discussed as an option. In other cases, active treatments, surgery, or radiation treatment should be discussed along with the potential side effects to allow shared decision-making.
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  • 文章类型: Journal Article
    本文提供的概述涵盖了关于复发性前列腺癌的挽救治疗的建议,旨在促进护理决策并帮助临床医生照顾在具有治愈意图的先前治疗后经历复发的患者。这是一个由三部分组成的系列的第一部分,重点是前列腺癌根治术(RP)后可疑生化复发(BCR)时的治疗决策。关于RP后非转移性BCR的治疗实施,请参阅第二部分;关于放疗(RT)和局灶治疗后复发的评估和处理,请参阅第三部分。区域性复发,和寡转移。
    通知本指南的系统评价是基于OvidMEDLINE中的搜索(1946年至2022年7月21日),Cochrane中央受控试验登记册(至2022年8月),和Cochrane系统评价数据库(至2022年8月)。更新搜索于2023年7月26日进行。通过审查相关文章的电子数据库参考清单来补充搜索。
    在AUA之间的合作努力中,ASTRO,而SUO,前列腺癌的挽救治疗小组制定了基于证据和共识的声明,为在临床局部疾病的初始确定局部治疗后经历BCR的患者的护理提供指导.
    推进诊断工具(尤其是成像)领域的工作,生物标志物,辐射输送,和生物操作与不断发展的医疗药物无疑将为患者提供新的机会,以体验他们的癌症的长期控制,同时尽量减少毒性。
    UNASSIGNED: The summary presented herein covers recommendations on salvage therapy for recurrent prostate cancer intended to facilitate care decisions and aid clinicians in caring for patients who have experienced a recurrence following prior treatment with curative intent. This is Part I of a three-part series focusing on treatment decision-making at the time of suspected biochemical recurrence (BCR) after radical prostatectomy (RP). Please refer to Part II for discussion of treatment delivery for non-metastatic BCR after RP and Part III for discussion of evaluation and management of recurrence after radiotherapy (RT) and focal therapy, regional recurrence, and oligometastasis.
    UNASSIGNED: The systematic review that informs this Guideline was based on searches in Ovid MEDLINE (1946 to July 21, 2022), Cochrane Central Register of Controlled Trials (through August 2022), and Cochrane Database of Systematic Reviews (through August 2022). Update searches were conducted on July 26, 2023. Searches were supplemented by reviewing electronic database reference lists of relevant articles.
    UNASSIGNED: In a collaborative effort between AUA, ASTRO, and SUO, the Salvage Therapy for Prostate Cancer Panel developed evidence- and consensus-based statements to provide guidance for the care of patients who experience BCR after initial definitive local therapy for clinically localized disease.
    UNASSIGNED: Advancing work in the area of diagnostic tools (particularly imaging), biomarkers, radiation delivery, and biological manipulation with the evolving armamentarium of therapeutic agents will undoubtedly present new opportunities for patients to experience long-term control of their cancer while minimizing toxicity.
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  • 文章类型: Journal Article
    本文提供的概述涵盖了关于复发性前列腺癌的挽救治疗的建议,旨在促进护理决策并帮助临床医生照顾在具有治愈意图的先前治疗后经历复发的患者。这是一个由三部分组成的系列的第三部分,重点是放疗(RT)和局灶性治疗后疑似非转移性复发的评估和管理。区域复发的评估和管理,分子影像学转移复发的管理,和未来的方向。有关治疗决策的讨论,请参阅第一部分,有关前列腺癌根治术(RP)后非转移性生化复发(BCR)的治疗提供的讨论。
    通知本指南的系统评价是基于OvidMEDLINE中的搜索(1946年至2022年7月21日),Cochrane中央受控试验登记册(至2022年8月),和Cochrane系统评价数据库(至2022年8月)。更新搜索于2023年7月26日进行。通过审查相关文章的电子数据库参考清单来补充搜索。
    在AUA之间的合作努力中,ASTRO,而SUO,前列腺癌挽救治疗指南小组制定了基于证据和共识的指南声明,为临床局部疾病的初始确定局部治疗后出现BCR的患者的护理提供指导.
    未来将需要为前列腺癌的多学科护理做出持续和深思熟虑的努力,以优化和改善接受挽救疗法治疗的患者的肿瘤和功能结果。
    UNASSIGNED: The summary presented herein covers recommendations on salvage therapy for recurrent prostate cancer intended to facilitate care decisions and aid clinicians in caring for patients who have experienced a recurrence following prior treatment with curative intent. This is Part III of a three-part series focusing on evaluation and management of suspected non-metastatic recurrence after radiotherapy (RT) and focal therapy, evaluation and management of regional recurrence, management for molecular imaging metastatic recurrence, and future directions. Please refer to Part I for discussion of treatment decision-making and Part II for discussion of treatment delivery for non-metastatic biochemical recurrence (BCR) after radical prostatectomy (RP).
    UNASSIGNED: The systematic review that informs this Guideline was based on searches in Ovid MEDLINE (1946 to July 21, 2022), Cochrane Central Register of Controlled Trials (through August 2022), and Cochrane Database of Systematic Reviews (through August 2022). Update searches were conducted on July 26, 2023. Searches were supplemented by reviewing electronic database reference lists of relevant articles.
    UNASSIGNED: In a collaborative effort between AUA, ASTRO, and SUO, the Salvage Therapy for Prostate Cancer Guideline Panel developed evidence- and consensus-based guideline statements to provide guidance for the care of patients who experience BCR after initial definitive local therapy for clinically localized disease.
    UNASSIGNED: Continuous and deliberate efforts for multidisciplinary care in prostate cancer will be required to optimize and improve the oncologic and functional outcomes of patients treated with salvage therapies in the future.
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  • 文章类型: Journal Article
    本文提供的概述涵盖了关于复发性前列腺癌的挽救治疗的建议,旨在促进护理决策并帮助临床医生照顾在具有治愈意图的先前治疗后经历复发的患者。这是一个由三部分组成的系列的第二部分,重点是原发性根治性前列腺切除术(RP)后非转移性生化复发(BCR)的治疗。有关治疗决策的讨论,请参阅第一部分,有关放疗(RT)和局部治疗后复发的评估和管理的讨论,请参阅第三部分。区域性复发,和寡转移。
    通知本指南的系统评价是基于OvidMEDLINE中的搜索(1946年至2022年7月21日),Cochrane中央受控试验登记册(至2022年8月),和Cochrane系统评价数据库(至2022年8月)。更新搜索于2023年7月26日进行。通过审查相关文章的电子数据库参考清单来补充搜索。
    在AUA之间的合作努力中,ASTRO,而SUO,前列腺癌挽救治疗小组制定了以证据和共识为基础的指南声明,为在临床局部疾病的初步确定局部治疗后出现BCR的患者的护理提供指导.
    优化和个性化抢救治疗方法仍然是泌尿生殖系统肿瘤学领域正在进行的工作领域,代表了需要良好协调的研究和临床护理领域,多学科的努力。
    UNASSIGNED: The summary presented herein covers recommendations on salvage therapy for recurrent prostate cancer intended to facilitate care decisions and aid clinicians in caring for patients who have experienced a recurrence following prior treatment with curative intent. This is Part II of a three-part series focusing on treatment delivery for non-metastatic biochemical recurrence (BCR) after primary radical prostatectomy (RP). Please refer to Part I for discussion of treatment decision-making and Part III for discussion of evaluation and management of recurrence after radiotherapy (RT) and focal therapy, regional recurrence, and oligometastasis.
    UNASSIGNED: The systematic review that informs this Guideline was based on searches in Ovid MEDLINE (1946 to July 21, 2022), Cochrane Central Register of Controlled Trials (through August 2022), and Cochrane Database of Systematic Reviews (through August 2022). Update searches were conducted on July 26, 2023. Searches were supplemented by reviewing electronic database reference lists of relevant articles.
    UNASSIGNED: In a collaborative effort between AUA, ASTRO, and SUO, the Salvage Therapy for Prostate Cancer Panel developed evidence- and consensus-based guideline statements to provide guidance for the care of patients who experience BCR after initial definitive local therapy for clinically localized disease.
    UNASSIGNED: Optimizing and personalizing the approach to salvage therapy remains an ongoing area of work in the field of genitourinary oncology and represents an area of research and clinical care that requires well-coordinated, multi-disciplinary efforts.
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  • 文章类型: Journal Article
    目的:对各种专业组织关于前列腺切除术后尿失禁(PPI)的治疗和管理的指南进行全面审查。
    方法:本综述包括以下指南:欧洲泌尿外科协会(EAU2023),美国泌尿外科协会/泌尿动力学学会,女性盆腔医学和泌尿生殖器重建(AUA/SUFU2019),失禁国际咨询(ICI,2018),加拿大泌尿外科协会(CUA,2012)和印度泌尿外科学会(USI,2018)。
    结果:一般来说,指南同意对前列腺切除术后尿失禁(PPI)患者进行全面病史和体格检查的重要性.然而,有关建议的额外调查的准则有所不同。在麻烦的PPI的情况下,男性吊索通常推荐用于轻度至中度尿失禁(UI),虽然人工尿道括约肌是中重度UI的首选,尽管这种严重程度的确切定义尚不清楚.AUA/SUFU和ICI提供的指南为术后并发症或持续性/复发性UI的管理提供了建议。尽管在这些建议中也可以观察到一些差异。
    结论:这是包含PPI指南的此类审查中的第一个,涵盖了十多年。尽管指导方针共享总体原则,细微差别的变化持续存在,给临床医生带来挑战。本汇编巩固并突出了准则之间的异同,为从业人员提供PPI诊断和管理的全面概述。我们预计,随着PPI管理的这一领域和其他领域出现更多证据,该指南将融合并解决以患者为中心的关键方面。
    OBJECTIVE: To provide a comprehensive review of guidelines from various professional organisations on the work-up and management of post-prostatectomy Incontinence (PPI).
    METHODS: The following guidelines were included in this review: European Association of Urology (EAU 2023), American Urological Association/Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction (AUA/SUFU 2019), International Consultation on Incontinence (ICI, 2018), the Canadian Urological Association (CUA, 2012) and the Urological Society of India (USI, 2018).
    RESULTS: In general, the guidelines concur regarding the significance of conducting a comprehensive history and physical examination for patients with post-prostatectomy incontinence (PPI). However, there are variations among the guidelines concerning the recommended additional investigations. In cases of troublesome PPI, male slings are typically recommended for mild to moderate urinary incontinence (UI), while artificial urinary sphincters are preferred for moderate to severe UI, although the precise definition of this severity remains unclear. The guidelines provided by AUA/SUFU and the ICI have offered suggestions for managing complications or persistent/recurrent UI post-surgery, though some differences can be observed within these recommendations as well.
    CONCLUSIONS: This is a first of its kind review encompassing Guidelines on PPI spanning over a decade. Although guidelines share overarching principles, nuanced variations persist, posing challenges for clinicians. This compilation consolidates and highlights both the similarities and differences among guidelines, providing a comprehensive overview of PPI diagnosis and management for practitioners. It is our expectation that as more evidence emerges in this and other areas of PPI management, the guidelines will converge and address crucial patient-centric aspects.
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  • 文章类型: Journal Article
    目的:评估当前NCCN前列腺癌指南中使用的研究中的种族数据。这些指南代表了为临床实践提供信息的最新信息。与白人患者相比,前列腺癌不成比例地影响黑人患者的死亡率,死亡率高2.1倍。然而,当将患者纳入研究时,这种种族差异并没有被考虑在内。
    方法:对最新NCCN指南中引用的研究进行了种族人口统计评估,以及它们是否正确地解释了黑人患者中前列腺癌的较高死亡率。然后,我们分析了前列腺癌中的主题。
    结果:应用排除标准后,878项研究中有547项被纳入分析;其中,只有32.4%包括人口统计数据。总的来说,黑人患者占总患者的472,476人(12.8%),而3,023,007(81.7%)患者为白人。这些发现与特定领域一致,包括风险分层(12%与75%),影像学和分期(11%vs.80%),治疗(16%vs.81%),复发(15%vs.73%),去势敏感性前列腺癌(9%vs.84%),去势抵抗前列腺癌(8%vs.73%),和转移性骨病(7%vs.84%)。
    结论:我们的分析一致表明,尽管指南使用了最好的研究,这些研究通常不报告种族人口统计学或患者人群不反映前列腺癌死亡率的种族差异。我们的研究质疑这些研究对黑人患者的推广。未来的研究应强调纳入种族人口统计学,并招募具有代表性的研究队列。
    To evaluate racial data in studies used in current NCCN prostate cancer guidelines. These guidelines represent the latest information that informs clinical practice. Prostate cancer disproportionately affects mortality in Black patients compared to White patients at a 2.1-fold higher death rate. However, this racial disparity is not accounted for when including patients in research.
    The studies referenced in the latest NCCN guidelines were evaluated for inclusion of racial demographics, and whether they properly account for the higher mortality rate of prostate cancer seen in Black patients. We then analyzed topics within prostate cancer.
    After application of exclusion criteria, 547 of 878 studies were included for analysis; of those, only 32.4% included demographic data. Overall, Black patients accounted for 472,476 (12.8%) of total patients, while 3,023,007 (81.7%) patients were White. These findings were consistent with specific areas including risk stratification (12% vs 75%), imaging and staging (11% vs 80%), treatment (16% vs 81%), recurrence (15% vs 73%), castration-sensitive prostate cancer (9% vs 84%), castration-resistant prostate cancer (8% vs 73%), and metastatic bone disease (7% vs 84%).
    Our analysis showed consistently that although the guidelines utilize the best research, such studies often do not report racial demographics or have patient populations that do not reflect racial differences in mortality of prostate cancer. Our study questions the generalization of these studies to Black patients. Future research should emphasize inclusion of racial demographics and recruit appropriately representative study cohorts.
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  • 文章类型: Journal Article
    在信息时代,患者会咨询新平台,以获得有关医疗的意识。这项研究的目的是评估计划进行根治性前列腺切除术(RP)的患者的视频共识(VC)管理的理解水平和可行性,将其与标准知情共识(SIC)进行比较。根据欧洲泌尿外科患者信息协会,我们为RP设置了一个视频内容,该视频内容被翻译成意大利语,并与可能的围手术期和术后并发症的信息一起实施,住院天数等。从2021年到2022年,在我们机构接受RP的所有患者都被前瞻性地纳入本研究。患者接受了SIC,之后,关于RP的VC。经过两个共识,患者接受了预先形成的Likert10量表和STAI问卷.在RP数据集上,选择了276例患者,并评估了552份SIC和VC问卷。在这些中,中位年龄为62岁(IQR60~65).与传统的知情同意(6.9/10)相比,患者对VC的总体满意度(8.8/10)更高。因此,VC可能在未来的手术中发挥作用,提高患者的自觉性和满意度,减少术前焦虑。
    In the age of information, new platforms are consulted by patients to acquire consciousness about medical treatments. The aim of this study was to assess the level of understanding and feasibility of video consensus (VC) administration in patients scheduled for radical prostatectomy (RP), comparing it with standard informed consensus (SIC). According to the European Association of Urology Patient Information, we set up a video content for RP that was translated in Italian and implemented with information about possible perioperative and postoperative complications, days of hospitalization etc. From 2021 to 2022, all patients undergoing RP at our institution were prospectively included in this study. Patients received an SIC and after that, a VC about RP. After two consensuses were administered, patients received a preformed Likert 10 scale and STAI questionnaires. On the RP dataset, 276 patients were selected and 552 questionnaires for both SIC and VC were evaluated. Out of these, the median age was 62 years (IQR 60-65). Patients reported a higher overall satisfaction for VC (8.8/10) compared to the traditional informed consent (6.9/10). Therefore, VC may play a role in the future of surgery, improving the consciousness and satisfaction of patients and reducing preoperative anxiety.
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  • 文章类型: Journal Article
    本文提供的摘要代表了专门针对临床局部前列腺癌的三部分系列的第二部分:AUA/ASTRO指南,讨论主动监测和手术的原则,以及对患者进行初级治疗后的随访。有关风险评估的讨论,请参阅第一部分和第三部分。分期,和基于风险的管理(第一部分),辐射原理和未来方向(第三部分)。
    用于告知本指南的系统评价是由独立的方法学顾问进行的。一名研究馆员在OvidMEDLINE进行了搜索,Cochrane中央控制试验登记册,和Cochrane系统评价数据库。方法学小组通过对先前AUA审查中包含的研究以及相关文章的参考文献列表进行补充,对电子数据库的搜索进行了补充。
    临床局部前列腺癌小组创建了基于证据和共识的指南声明,以帮助临床医生管理临床局部前列腺癌患者。关于主动监测的声明,手术管理,和病人的随访是详细的。
    本指南旨在告知临床医生治疗患有临床局限性前列腺癌的患者。继续研究和发表来自未来试验的高质量证据对于进一步改善对这些男性的护理至关重要。
    The summary presented herein represents Part II of the three-part series dedicated to Clinically Localized Prostate Cancer: AUA/ASTRO Guideline, discussing principles of active surveillance and surgery as well as follow-up for patients after primary treatment. Please refer to Parts I and III for discussion of risk assessment, staging, and risk-based management (Part I), and principles of radiation and future directions (Part III).
    The systematic review utilized to inform this guideline was conducted by an independent methodological consultant. A research librarian conducted searches in Ovid MEDLINE, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews. The methodology team supplemented searches of electronic databases with the studies included in the prior AUA review and by reviewing reference lists of relevant articles.
    The Clinically Localized Prostate Cancer Panel created evidence- and consensus-based guideline statements to aid clinicians in the management of patients with clinically localized prostate cancer. Statements regarding active surveillance, surgical management, and patient follow-up are detailed.
    This guideline aims to inform clinicians treating patients with clinically localized prostate cancer. Continued research and publication of high-quality evidence from future trials will be essential to further improve care for these men.
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  • 文章类型: Journal Article
    本文提供的概述代表了专门针对临床局部前列腺癌的三部分系列的第一部分:AUA/ASTRO指南,讨论风险评估,分期,诊断为临床局限性前列腺癌的患者的基于风险的管理。有关主动监视原则的讨论,请参阅第二和第三部分,手术和随访(第二部分),辐射原理和未来方向(第三部分)。
    用于告知本指南的系统评价是由独立的方法学顾问进行的。一名研究馆员在OvidMEDLINE进行了搜索,Cochrane中央控制试验登记册,和Cochrane系统评价数据库。方法学小组通过对先前AUA审查中包含的研究以及相关文章的参考文献列表进行补充,对电子数据库的搜索进行了补充。
    临床局部前列腺癌小组创建了基于证据和共识的指南声明,以帮助临床医生管理临床局部前列腺癌患者。关于风险评估的声明,分期,和基于风险的管理在这里详细介绍。
    本指南旨在告知临床医生治疗患有临床局限性前列腺癌的患者。继续研究和发表来自未来试验的高质量证据对于进一步改善对这些男性的护理至关重要。
    The summary presented herein represents Part I of the three-part series dedicated to Clinically Localized Prostate Cancer: AUA/ASTRO Guideline, discussing risk assessment, staging, and risk-based management in patients diagnosed with clinically localized prostate cancer. Please refer to Parts II and III for discussion of principles of active surveillance, surgery and follow-up (Part II), and principles of radiation and future directions (Part III).
    The systematic review utilized to inform this guideline was conducted by an independent methodological consultant. A research librarian conducted searches in Ovid MEDLINE, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews. The methodology team supplemented searches of electronic databases with the studies included in the prior AUA review and by reviewing reference lists of relevant articles.
    The Clinically Localized Prostate Cancer Panel created evidence- and consensus-based guideline statements to aid clinicians in the management of patients with clinically localized prostate cancer. Statements regarding risk assessment, staging, and risk-based management are detailed herein.
    This guideline aims to inform clinicians treating patients with clinically localized prostate cancer. Continued research and publication of high-quality evidence from future trials will be essential to further improve care for these men.
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