Evidence-based guidelines, advancing with the times-2021 version of "CSCO Prostate Cancer Diagnosis and Treatment Guidelines" is officially released!

As the average life expectancy in China has gradually increased, changes in eating habits and life>
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The CSCO (Chinese Society of Clinical Oncology) Prostate Cancer Expert Committee, in response to the urgent needs of the majority of prostate cancer patients in China, promoted standardized treatment concepts to clinicians in urology oncology departments across the country, and released the first edition of the CSCO Guidelines for Diagnosis and Treatment of Prostate Cancer last year
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The guide group leader is Professor Ye Dingwei, the deputy team leaders are Professor Guo Jun, Professor He Zhisong, Professor Qi Jun, Professor Shi Benkang, Professor Wei Qiang, Professor Xie Xiaodong and Professor Zhou Fangjian, and the secretary is Professor Zhu Yao
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Writing experts: Professor Zhu Yao, Professor Sheng Xinan, Professor Fan Yu, Professor Liu Hailong, Professor Chen Shouzhen, Professor Zeng Hao, Professor Guo Fang, Professor Li Yonghong, Professor He Liru and Professor Gu Weijie
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After the official release of the guidelines, the response was overwhelmingly popular, and it quickly became the most important and authoritative reference material for the majority of urology medical staff in clinical work, which greatly helped and promoted the standardized process of prostate cancer diagnosis and treatment in China
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In order to maintain the advanced nature and timeliness of the guidelines, the CSCO Prostate Cancer Committee and the guidelines writing team officially launched the update and revision of the 2021 guidelines in March this year
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Based on the latest important research and progress published in the field of prostate cancer at home and abroad in the past year, the writing team has repeatedly discussed and revised several times.
The 2021 version of the "Guidelines for Diagnosis and Treatment of Prostate Cancer" was finalized and an online press conference was officially held on June 3.
! The press conference was broadcast live by the China Urinary Oncology MDT platform, and jointly broadcast by third-party cooperation platforms such as Oncology Watch, Oncology Information, Medical Circles, U Medical Station, CCMTV, and Yimaitong.
The total number of online viewers exceeded 10,000
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At the beginning of the meeting, Professor Ye Dingwei, chairman of the CSCO Prostate Specialty Committee and leader of the CSCO Prostate Cancer Diagnosis and Treatment Guidelines Compilation Group, gave a wonderful speech, and pointed out that the update of the CSCO Prostate Cancer Diagnosis and Treatment Guidelines was carried out by the CSCO Prostate Specialty Committee.
The chairperson, the deputy chairpersons, and the writing experts are based on the latest high-quality evidence-based medical evidence in the field of prostate cancer at home and abroad, after repeated discussions and careful polishing
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It is especially worth mentioning that one of the highlights of the update of this guideline is the addition and quotation of more Chinese scholars based on the high-quality research of the Chinese population.
It is gratifying to see that Chinese experts and scholars have improved in the field of prostate cancer There have been more and more in-depth explorations, and these explorations will eventually benefit patients through the guidelines and have far-reaching value and significance
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Next, let's take a quick look and see what has been updated in the 2021 version of the CSCO Prostate Cancer Diagnosis and Treatment Guide! In the press conference, Professor Zhu Yao from the Cancer Hospital of Fudan University shared the revision process of the CSCO prostate cancer diagnosis and treatment guidelines, and specifically pointed out the updated principles and characteristics of the guidelines: evidence-based medicine, keeping pace with the times; precision medicine, Diagnosis goes first; medicines are available, treatment value; local data, leading guidelines
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In particular, it emphasizes the revision of the CSCO prostate cancer guidelines, and pays more attention to citing high-quality evidence-based medical data based on the Chinese population, such as from the Fudan University Affiliated Cancer Hospital, Sun Yat-sen University Cancer Center and Shandong University Qilu Hospital.
Important research on prostate cancer screening and diagnosis, gene mutation epidemiology, and treatment of metastatic prostate cancer
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It is expected that more Chinese prostate cancer research will be written into the guidelines in the future, which will eventually guide clinical practice
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Prostate cancer MDT diagnosis and treatment model, prostate cancer gene detection and liquid biopsy, prostate cancer follow-up Professor Zeng Hao introduced the "prostate cancer MDT diagnosis and treatment model", "prostate cancer gene detection and liquid biopsy" and "prostate cancer follow-up" three Update points for chapters
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There are mainly the following aspects: MDT diagnosis and treatment mode of prostate cancer a.
More attention and emphasis on the importance of MDT; b.
Pointing out that clinical trials may bring better treatment opportunities for patients, and prostate cancer patients should be encouraged to participate after evaluation Clinical trials; c.
emphasized that network-based telemedicine can also provide treatment advice to patients
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Prostate cancer genetic testing and liquid biopsy a.
The type of detected patient is updated to metastatic prostate cancer: It is recommended that patients with metastatic prostate cancer undergo genetic testing of tumor samples, and genetic testing can be considered for patients with limited-stage prostate cancer; b.
The type of sample tested is updated to: Tumor tissue + plasma ctDNA samples + germline specimens; c.
Level III recommended "other genes related to the treatment and prognosis of prostate cancer" increase the TP53, PTEN and RB1 genes
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Follow-up a.
In the follow-up after endocrine therapy, it is recommended to increase bone mineral density testing at level I; b.
For M1 patients, even if there is no PSA progression, routine imaging examinations are also recommended
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Prostate Cancer Screening and Diagnosis of Prostate Cancer Professor Chen Shouzhen introduced the updated points of the chapters on "Prostate Cancer Screening" and "Prostate Cancer Diagnosis"
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Mainly include the following aspects: a.
Updated the correlation data between the Chinese population's prostate cancer screening strategy and the 5-year survival rate; b.
Added the research data on the correlation between the prostate health index cut-point value and the incidence rate in the Chinese population ; C.
Increased the latest data on the incidence of infection complications in transrectal and transperineal biopsy; d.
Emphasizes the need to pay attention to the application of antibiotics in transrectal puncture
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Treatment of Localized Prostate Cancer In this chapter, Professor Fan Yu, Professor Li Yonghong and Professor He Liru respectively introduced the updated points of the chapter "Treatment of Localized Prostate Cancer"
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The main aspects are as follows: a.
Emphasizes that with the acceleration of the aging of our country's population, it is particularly important to properly evaluate patients, adjust treatment plans according to the patient's health status rather than age, and monitor adverse events; increase the Chinese population Life expectancy related information; b.
For extremely low-risk patients, BRAC1/2 testing is added for candidates who are actively monitored.
Active monitoring is not recommended for patients with positive results; c.
Based on the latest research and evidence, modified The specific plan of external radiotherapy for prostate cancer and the indications of low-dose rate brachytherapy; d.
Describe the scope of pelvic lymph node dissection more clearly; Increase the latest evidence of lymph node dissection; e.
Add postoperative adjuvant radiotherapy vs.
The latest research to save radiotherapy
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Diagnosis and treatment of prostate cancer recurrence after curative treatment This chapter introduces the updated points of the chapter "Diagnosis and treatment of prostate cancer recurrence after curative treatment" by Professor Liu Hailong
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Mainly include the following aspects: a.
Check and evaluate the recurrence after radical prostatectomy, modify the prostate MRI to be more accurate pelvic MRI; adjust the chest CT from the I recommendation to the II recommendation; consider the level of evidence and the general applicability of the application Increased the recommendation level of PSMA/PET-CT, and placed it before choline PET-CT; added PSA-DT calculator; b.
increased the latest research evidence of salvage lymph node dissection; c.
increased oligometastasis The latest research evidence of radiotherapy
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Diagnosis and treatment of metastatic hormone-sensitive prostate cancer In this chapter, Professor Guo Fang introduced the updated points of the chapter "Diagnosis and treatment of metastatic hormone-sensitive prostate cancer"
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The main aspects are as follows: a.
In the treatment of metastatic hormone-sensitive prostate cancer, the level I recommended "ADT alone" is revised to "ADT-based combination therapy": For patients with metastatic prostate cancer first diagnosed, if There are no contraindications to the combination therapy, enough life expectancy to benefit from the combination therapy, and willing to accept the increased risk of side effects, do not perform ADT alone for them, and should be combined with other treatments on the basis of ADT; b.
Update The latest follow-up data of the STAMPEDE study; c.
Based on the research data of the Chinese population, add ADT + cryotherapy to the level III recommendation
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Diagnosis and Treatment of Castration-resistant Prostate Cancer In this chapter, Professor Sheng Xinan introduced the updated points of the chapter "Diagnosis and Treatment of Castration-resistant Prostate Cancer"
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There are mainly the following aspects: a.
In the treatment of non-metastatic castration-resistant prostate cancer, the latest OS data from the ARAMIS study and the PROSPER study have been updated; b.
The treatment of metastatic castration-resistant prostate cancer: treatment recommendation table Re-draw the classification method using whether you have received new endocrine therapy/chemotherapy in the past to replace the first-line, second-line, and third-line therapies in the old version; increase the real-world research data of olaparib in China; "the first-line new endocrine therapy failed without chemotherapy" Level III recommends adding "abiraterone/dexamethasone" and adding domestic retrospective studies; considering that "cabazitaxel" is not available in China, it is adjusted from level I recommendation to level II recommendation; "previous new endocrine therapy and docetaxel In the level II recommendation of “Failure of Chemotherapy”, “Docetaxel” is added to challenge again; level III recommendation is added “Clinical Research”; c.
In the prevention and treatment of bone-related events: add the definition of “bone-related events”; add disulumab Precautions for the use of zoledronic acid and zoledronic acid; add "pain-killing drugs" use principles, drug selection and precautions
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At the end of the press conference, Professor Xie Xiaodong, vice chairman of the CSCO Prostate Specialty Committee, made a wonderful summary: The 2021 version of the "CSCO Prostate Cancer Diagnosis and Treatment Guidelines" has been updated and revised.
After repeated discussions and revisions, it has gathered my country’s top urology experts.
With the wisdom and experience of scholars, I hope that the majority of urology colleagues can make full use of this guide.
I also hope that this guide can continue to provide reference and basis for the clinical work of the majority of urologists, and further promote the diagnosis and treatment of prostate cancer in my country.
One floor! Source: Frontiers of Prostate Cancer Information