title: Treatment trends for clinically localised prostate cancer. National population analysis: GESCAP group.
abstract: OBJECTIVE
  To describe the established therapies for localised prostate cancer (PC) in Spain and to assess compliance with the 2010 UAE guidelines.
  
  
  METHODS
  This was an epidemiological, observational, prospective and multicentre study. Of the 3,918 patients diagnosed with PC during 2010, only those patients with localised PC were included. Follow-up was ultimately conducted for a minimum of one year from the diagnosis for 3,713 patients (94.77%). The treatment groups assessed were as follows: radical prostatectomy, radiation therapy, hormone therapy, brachytherapy, active surveillance or observation and experimental local treatment (cryotherapy or other treatment). Compliance with the recommendations of the EAU guidelines was studied, describing the treatment groups according to D'Amico risk stratification criteria (localised [low, intermediate and high risk] and locally advanced), age, PSA and Gleason score.
  
  
  RESULTS
  By applying the D'Amico criteria, we included 3,641 (92.93%) patients. Based on the UAE recommendations: 1) 68.87% of the patients at low-intermediate risk aged≤65 years underwent radical prostatectomy; 2) 34.51% of the patients>65 years at high risk with locally advanced disease were administered radiation therapy and hormone therapy; 3) 30.36% of the patients at high risk with locally advanced disease were only treated with hormone therapy; 4) 15.20% of the patients at low risk were only treated with brachytherapy; 5) active surveillance or observation was selected for 2.44% of the patients aged≤65 years and for 10.63% of the patients at low-intermediate risk who were>65 years. Lastly, 86.5% of the patients at low risk underwent a single treatment, and 43.62% of the patients at high risk with locally advanced disease underwent combined treatments.
  
  
  CONCLUSIONS
  This is the first national European study to evaluate the therapeutic management of localised PC based on the risk group to which the patient belonged. Most young patients (≤65 years) with low-intermediate risk localised PC were treated with surgery, which adheres to the recommendations of the 2010 UAE guidelines. Various therapeutic combinations have been employed for patients with high-risk, locally advanced localised tumours, revealing the need for a multidisciplinary approach (Controlled-trials.com number: ISRCTN19893319).
authors.affiliation: Departamento de Urología, Hospital Morales Meseguer, Murcia, España; Cátedra de Urología, Universidad Católica San Antonio (UCAM), Murcia, España. Electronic address: minana@gmail.com.
authors.forename: B
authors.initials: B
authors.lastname: Miñana
authors.affiliation: Hospital Universitario 12 de Octubre, Madrid, España.
authors.forename: A
authors.initials: A
authors.lastname: Rodríguez-Antolín
authors.affiliation: Complejo Hospitalario Universitario A Coruña, A Coruña, España.
authors.forename: F
authors.initials: F
authors.lastname: Gómez-Veiga
authors.affiliation: Hospital Gregorio Marañón, Madrid, España.
authors.forename: C
authors.initials: C
authors.lastname: Hernández
authors.affiliation: Hospital de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España.
authors.forename: J F
authors.initials: JF
authors.lastname: Suárez
authors.affiliation: Hospital Universitario Central de Asturias, Oviedo, Asturias, España.
authors.forename: J M
authors.initials: JM
authors.lastname: Fernández-Gómez
authors.affiliation: Hospital de Basurto, Bilbao, Vizcaya, España.
authors.forename: M
authors.initials: M
authors.lastname: Unda
authors.affiliation: Hospital Ramón y Cajal, Madrid, España.
authors.forename: J
authors.initials: J
authors.lastname: Burgos
authors.affiliation: Hospital Clínic i Provincial, Barcelona, España.
authors.forename: A
authors.initials: A
authors.lastname: Alcaraz
authors.affiliation: Hospital Universitario de Canarias, San Cristóbal de la Laguna, Santa Cruz de Tenerife, España.
authors.forename: P
authors.initials: P
authors.lastname: Rodríguez
authors.affiliation: Departamento Médico, Astellas Pharma S. A., Madrid, España.
authors.forename: C
authors.initials: C
authors.lastname: Moreno
authors.affiliation: Departamento Médico, Astellas Pharma S. A., Madrid, España.
authors.forename: E
authors.initials: E
authors.lastname: Pedrosa
authors.affiliation: Hospital Virgen de las Nieves, Granada, España.
authors.forename: J M
authors.initials: JM
authors.lastname: Cózar
mesh_terms: D000368:Aged; D016021:Epidemiologic Studies; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000628:therapy*; D013030:Spain / Q000453:epidemiology
keywords: Cáncer de próstata; España; Guidelines; Guías; Prostate cancer; Spain; Tratamiento; Treatment