A group of Spanish experts of different specialties participated in the ENFOCA2 project, promoted by the Spanish Oncology Genitourinary Group (SOGUG), which was designed to provide updated information on current and novel aspects contributing to the optimal care of prostate cancer (PCa) patients. In localized disease, it is important to implement strategic alliances with other institutions for improving adherence to active surveillance in low-risk groups and to explore genetic testing for a better indication of focal therapy. Local control of the disease should be maximized to prevent local failure and biochemical recurrence. In patients with locally advanced disease, with PSMA PET/CT-positive lesions in M0 staging on conventional imaging techniques, therapeutic decisions should be carefully evaluated due to insufficient evidence regarding the gold standard in this setting. In patients with metastatic castration-resistant PCa (mCRPC), assessment ofBRCAsomatic and germline mutations provides prognostic information and familial cancer risk and informs treatment decisions. Combinations of androgen receptor signaling inhibitor (ARSi) agents and poly-ADP ribose polymerase inhibitors (PARPi) are emerging alternatives for advanced PCa. The oldest segment of PCa patients (>70 years of age) may require geriatric assessment to evaluate physical and functional reserves, tailoring treatment to their individual characteristics and circumstances. The concept of a comprehensive multidisciplinary approach together with inter-center and/or inter-specialty therapeutic alliances should be implemented in the routine care of patients with PCa.
西班牙多学科专家团队参与了由西班牙泌尿生殖肿瘤学组（SOGUG）发起的ENFOCA2项目，该项目旨在为前列腺癌患者的最佳诊疗提供当前及新兴领域的更新信息。对于局限性前列腺癌，需建立跨机构战略联盟以提高低危患者对主动监测的依从性，并探索基因检测以优化局部治疗的适应症选择。应最大化局部疾病控制，以预防局部进展和生化复发。对于传统影像学分期为M0但PSMA PET/CT显示阳性病灶的局部晚期患者，因该领域金标准治疗证据不足，需审慎评估治疗决策。在转移性去势抵抗性前列腺癌患者中，BRCA体细胞与胚系突变检测可提供预后信息、评估家族癌症风险并指导治疗决策。雄激素受体信号抑制剂与聚腺苷二磷酸核糖聚合酶抑制剂的联合方案正成为晚期前列腺癌的新兴选择。对于高龄患者（>70岁），需通过老年综合评估其生理与功能储备，根据个体特征制定个体化治疗方案。应将多学科综合诊疗理念及跨中心/跨专科治疗联盟模式纳入前列腺癌的常规临床实践。
肿瘤(癌症)患者之家