LOCALISED PROSTATE CANCER

1. What are the prognostic factors in localised prostate cancer?
2. In patients with clinically localised prostate cancer, what is the safety and efficacy of different treatment options?
   
3. In patients with clinically localised prostate cancer in which surgery is indicated, what is the safety and efficacy of different types of radical laparoscopy surgery (transperitoneal or extraperitoneal, robot-assisted or not) in comparison with open radical prostatectomy?
   
4. In a patient with clinically localised prostate cancer who is indicated radical surgery with intent to cure, does lymphadenectomy increase the cure rates of the disease? If performed, which is better, extended or limited lymphadenectomy?
   
5. In patients with clinically localised prostate cancer where a radical prostatectomy is indicated, what percentage of positive surgical margins are obtained when it is decided to keep or not keep the neurovascular bundles (uni- or bilaterally)? And what results are obtained regarding urinary incontinence and erectile dysfunction?
   
6. In patients with clinically localised or locally advanced prostate cancer in which radiation is indicated (external and/or brachytherapy), what volume, dose and fractionation have the best safety and efficacy according to the risk?
   
7. In patients with clinically localised prostate cancer treated with intent to cure, does implementation of a neoadjuvant or adjuvant hormonal treatment improve the disease cure rates?
   
8. When can surveillance be stopped for a patient with localised prostate cancer after attempting a cure (radical prostatectomy and radical radiotherapy)? What tests are performed and how often do they take place?

LOCALLY ADVANCED PROSTATE CANCER

9. What is the safest treatment and most effective option for a patient with prostate cancer at the locally advanced clinical stage?
   
10. In a patient who has undergone radical prostatectomy in which locally advanced prostate cancer and/or positive microscopic surgical margins are demonstrated, is it safer and more effective to establish an adjuvant treatment (radiation) or not?
    
11. In patients with prostate cancer at a locally advanced clinical stage in which surgery is indicated, does carrying out a lymphadenectomy increase cure rates for the disease? And if carried out, which is better, extended or limited lymphadenectomy?
12. In patients with locally advanced prostate cancer subjected to local treatment (such as radiation or surgery) associated with hormone therapy, which form of hormone treatment is the safest and most effective: monotherapy with antiandrogens, monotherapy with LHRH agonists or complete androgenic blockade?

PROSTATE CANCER IN PSA RELAPSE

13. In patients with prostate cancer subjected to prostatectomy or radiotherapy with intent to cure, what would be the best analytical criteria for the diagnosis of PSA relapse?
    
14. In patients with PSA relapse after radical prostatectomy, what kind of salvage intervention is safer and more effective?
    
15. In patients with PSA relapse after radiotherapy or brachytherapy with intent to cure, what kind of salvage intervention is safer and more effective?
    
16. In those patients subjected to curative treatment who are in PSA relapse and for whom hormone therapy (active treatment) is indicated, when should this start?
    
17. In those patients subjected to curative treatment who are in PSA relapse and for whom hormone treatment is indicated, is it safer and more effective to apply this continuously or intermittently?

DISSEMINATED PROSTATE CANCER

18. In patients with disseminated prostate cancer, which is the safer and more effective treatment: complete androgen blockade or castration (surgical or chemical)?
    
19. In patients with disseminated prostate cancer (affecting the lymph node and/or metastasis), which is safer and more effective: immediate hormone therapy or deferred hormone treatment?
    
20. In patients with disseminated prostate cancer, which hormone treatment is safer and more effective: continuous or intermittent? And with what treatment guidelines?
    
21. In patients with disseminated prostate cancer where first line hormone therapy has failed (androgen suppression, complete androgen blockade) and the PSA is beginning to increase, which is safer and more effective: continuing to follow lines of hormonal treatment or start chemotherapy?
    
22. In patients with androgen-independent disseminated prostate cancer, which is safer and more effective for the improvement of overall survival, clinical or biochemical response, progression-free survival and reduced side effects: oestramustine, mitoxantrone, docetaxel , docetaxel-oestramustine, vinorelbine or etoposide?
    
23. In patients with androgen-independent prostate cancer who are going to receive chemotherapy, is it safer and more effective to start when biochemical progression is seen or to wait for clinical progression?
    
24. In patients with disseminated prostate cancer in progression who have received hormone treatment and are going to receive chemotherapy, does removing the LH-RH agonists affect the safety and efficacy of the treatment?
    
25. In patients with disseminated prostate cancer, does intervention with bisphosphonates (zoledronic acid), compared with doing nothing, improve event-free survival for bones, bone pain and the quality of life, and does it allow a reduction in painkiller dosage?
    
26. In patients with disseminated prostate cancer, does allowing the administration of radiopharmaceuticals lead to a better control and/or a reduction of metastatic bone pain?