CLINICAL GUIDELINES FOR DIAGNOSING, TREATMENT AND MONITORING PATIENTS WITH PROSTATE CANCER – CROATIAN ONCOLOGY SOCIETY AND CROATIAN UROLOGY SOCIETY, CROATIAN MEDICAL ASSOCIATION
Autori:
Mladen Solarić, Mislav Grgić, Tomislav Omrčen, Marija Petković, Ana Fröbe, Nenad Belaj, Robert Zorica, Božo Krušlin, Gordana Đorđević, Željko Kaštelan, Boris Ružić, Ivan Gilja, Ivan Krolo, Katarina Vilović, Davor Librenjak, Eduard Vrdoljak, Marijan Šitum, Ranka Štern Padovan, Željko Vojnović
Sažetak
Adenokarcinom prostate druga je po učestalosti zloćudna neoplazija u muškaraca u Republici Hrvatskoj. Klinički je često asimptomatski, a najčešće se otkriva na osnovi povišenih vrijednosti PSA u serumu. Odluka o liječenju donosi se na osnovi TNM-klasifikacije, Gleasonova gradusa (stupnja diferenciranosti) i vrijednosti PSA. Klinički lokalizirana bolest liječi se vrlo uspješno radikalnom prostatektomijom ili radikalnom radioterapijom s hormonskom terapijom ili bez nje. Klinički lokalno uznapredovala bolest najčešće se liječi združenom primjenom radikalne radioterapije i hormonske terapije. Metastatska bolest može se godinama kontrolirati androgenom deprivacijom, a nakon razvoja bolesti rezistentne na kastraciju opravdana je kemoterapija ili dodatni oblici hormonske terapije. U tekstu koji slijedi predstavljene su kliničke upute s ciljem standardizacije postupaka i kriterija postavljanja dijagnoze, liječenja te praćenja bolesnika s rakom prostate u Republici Hrvatskoj.
Summary
Prostate adenocarcinoma is the second most common solid neoplasm in male population in Croatia. It rarely causes symptoms unless it is advanced. The finding of PSA rise is the most common reason for diagnostic workout. Treatment plan is based on TNM classification, Gleason score and PSA. Clinically localized disease is successfully treated by radical prostatectomy or radiotherapy with or without hormonal therapy. Locally advanced disease is treated with radiotherapy and hormonal therapy. Metastatic disease can be controlled for many years by androgen deprivation. For castration resistant disease appropriate treatment is chemotherapy or secondary hormonal therapy. The following paper presents the clinical guidelines in order to standardize procedures and criteria for the diagnosis, management, management, treatment and monitoring of patients with prostate cancer in the Republic of Croatia.
