Alcaraz Asensio A, Alvarez Ossorio J L, Cozar Olmo J M, Chantada Abal V, Juarez Soto A, Linares Espinos E, Moreno Jimenez J, Muñoz Rodriguez J, Perez Fentes D, Plata Bello A, Rodrigo Aliaga M, Unda Urzaiz M, Vilaseca A
Servicio de Urología, Hospital Clinic de Barcelona, Barcelona, Spain.
Servicio de Urología, Hospital Puerta del Mar, Cadiz, Spain.
Actas Urol Esp (Engl Ed). 2022 May;46(4):193-213. doi: 10.1016/j.acuroe.2021.11.001. Epub 2022 Mar 16.
Survival and quality of life (QoL) of patients with non-metastatic castration-resistant prostate cancer (nmCRPC) deteriorate significantly when they develop metastases. New generation antiandrogens (apalutamide, enzalutamide and darolutamide) can prolong metastasis-free survival (MFS) and overall survival (OS) in these patients, maintaining their QoL.
After the performance of a systematic review of the literature, a scientific committee reached a consensus on simple and practical recommendations to consolidate and improve the management of patients with nmCRPC in urology consultations.
Recommendations are made on the frequency of PSA determination and imaging tests in patients with nmCRPC. The importance of co-morbidities in patients with nmCRPC is also highlighted, and recommendations are also made on functional and QoL assessment that can be carried out during urology consultations. The efficacy, safety, and effects on QoL of new generation antiandrogens are reviewed.
To evaluate treatment of patients with nmCRPC, it is necessary to consider co-morbidities and QoL, in addition to age. New generation antiandrogens are a safe and effective treatment option for patients with nmCRPC. The recommendations of this review can be helpful in optimizing the management of nmCRPC patients in urology consultations.
非转移性去势抵抗性前列腺癌（nmCRPC）患者发生转移时，其生存及生活质量（QoL）会显著恶化。新一代抗雄激素药物（阿帕他胺、恩杂鲁胺和达罗他胺）可延长这些患者的无转移生存期（MFS）和总生存期（OS），并维持其生活质量。
在对文献进行系统综述后，一个科学委员会就简单实用的建议达成共识，以巩固和改善泌尿外科门诊中nmCRPC患者的管理。
针对nmCRPC患者的PSA测定频率和影像学检查提出了建议。还强调了nmCRPC患者合并症的重要性，并就泌尿外科门诊期间可进行的功能和生活质量评估提出了建议。对新一代抗雄激素药物的疗效、安全性及对生活质量的影响进行了综述。
评估nmCRPC患者的治疗时，除年龄外，还需考虑合并症和生活质量。新一代抗雄激素药物是nmCRPC患者安全有效的治疗选择。本综述的建议有助于优化泌尿外科门诊中nmCRPC患者的管理。
