title: First Brazilian Consensus of Advanced Prostate Cancer: Recommendations for Clinical Practice.
abstract: BACKGROUND
  Prostate cancer still represents a major cause of morbidity, and still about 20% of men with the disease are diagnosed or will progress to the advanced stage without the possibility of curative treatment. Despite the recent advances in scientific and technological knowledge and the availability of new therapies, there is still considerable heterogeneity in the therapeutic approaches for metastatic prostate cancer.
  
  
  OBJECTIVE
  This article presents a summary of the I Brazilian Consensus on Advanced Prostate Cancer, conducted by the Brazilian Society of Urology and Brazilian Society of Clinical Oncology.
  
  
  METHODS
  Experts were selected by the medical societies involved. Forty issues regarding controversial issues in advanced disease were previously elaborated. The panel met for consensus, with a threshold established for 2/3 of the participants.
  
  
  CONCLUSIONS
  The treatment of advanced prostate cancer is complex, due to the existence of a large number of therapies, with different response profiles and toxicities. The panel addressed recommendations on preferred choice of therapies, indicators that would justify their change, and indicated some strategies for better sequencing of treatment in order to maximize the potential for disease control with the available therapeutic arsenal. The lack of consensus on some topics clearly indicates the absence of strong evidence for some decisions.
authors.affiliation: Clínica Médica, Unicamp, Campinas, SP, Brasil.
authors.forename: Andre Deeke
authors.initials: AD
authors.lastname: Sasse
authors.affiliation: Sociedade Brasileira de Oncologia Clinica, Belo Horizonte, MG, Brasil.
authors.forename: Evanius Garcia
authors.initials: EG
authors.lastname: Wiermann
authors.affiliation: Instituto Nacional do Câncer, INCA, Rio de Janeiro, RJ, Brasil.
authors.forename: Daniel
authors.initials: D
authors.lastname: Herchenhorn
authors.affiliation: Departamento de Oncologia, Instituto do Cancer do Estado de Sao Paulo, São Paulo, SP, Brasil.|Departamento de Oncologia, Hospital Sirio-Libanes, São Paulo, SP, Brasil.
authors.forename: Diogo Assed
authors.initials: DA
authors.lastname: Bastos
authors.affiliation: Beneficiência Portuguesa de São Paulo, São Paulo, SP, Brasil.
authors.forename: Fabio A
authors.initials: FA
authors.lastname: Schutz
authors.affiliation: Beneficiência Portuguesa de São Paulo, São Paulo, SP, Brasil.|Departamento de Oncologia, Hospital Israelita Albert Einstein, São Paulo, SP, Brasil.
authors.forename: Fernando Cotait
authors.initials: FC
authors.lastname: Maluf
authors.affiliation: Instituto do Câncer, Hospital das Clinicas da Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: George
authors.initials: G
authors.lastname: Coura
authors.affiliation: Universidade Católica de Brasilia, Taguatinga, DF, Brasil.
authors.forename: Igor Alexandre Protzner
authors.initials: IAP
authors.lastname: Morbeck
authors.affiliation: Universidade de São Paulo, USP, São Paulo, SP, Brasil.
authors.forename: Juliano J
authors.initials: JJ
authors.lastname: Cerci
authors.affiliation: Departamento de Oncologia, Hospital Israelita Albert Einstein, São Paulo, SP, Brasil.
authors.forename: Oren
authors.initials: O
authors.lastname: Smaletz
authors.affiliation: Oncocentro, Belo Horizonte, MG, Brasil.
authors.forename: Volney Soares
authors.initials: VS
authors.lastname: Lima
authors.affiliation: Departamento de Urologia, Hospital Santa Casa, Curitiba, PR, Brasil.
authors.forename: Ari
authors.initials: A
authors.lastname: Adamy
authors.affiliation: Instituto Nacional do Câncer, INCA, Rio de Janeiro, RJ, Brasil.
authors.forename: Franz Santos de
authors.initials: FS
authors.lastname: Campos
authors.affiliation: Departamento de Cirurgia e Departamento de Urologia, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brasil.
authors.forename: Gustavo Franco
authors.initials: GF
authors.lastname: Carvalhal
authors.affiliation: Hospital Federal Cardoso Fontes, Rio de Janeiro, RJ, Brasil.
authors.forename: Leandro Casemiro
authors.initials: LC
authors.lastname: Cezar
authors.affiliation: Departamento de Urologia, Universidade de São Paulo, USP, São Paulo, SP, Brasil.
authors.forename: Marcos Francisco
authors.initials: MF
authors.lastname: Dall'Oglio
authors.affiliation: Universidade Federal de São Paulo, São Paulo, SP, Brasil.
authors.forename: Marcus Vinicius
authors.initials: MV
authors.lastname: Sadi
authors.affiliation: Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
authors.forename: Rodolfo Borges Dos
authors.initials: RBD
authors.lastname: Reis
authors.affiliation: Departamento de Urologia, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte. MG, Brasil.
authors.forename: Lucas
authors.initials: L
authors.lastname: Nogueira
mesh_terms: D001938:Brazil; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D011467:Prostate / Q000473:pathology; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000628:therapy*
keywords: Diagnosis; Practice Guideline [Publication Type]; Prostatic Neoplasms 