Recommendations for research

The guideline committee has made the following recommendations for research.

As part of the 2021 update, the guideline committee made an additional recommendation for research on the diagnostic accuracy of staging investigations for Cambridge Prognostic Group (CPG) 3 prostate cancer.

Key recommendations for research

1 Follow up during active surveillance

What is the most suitable surveillance protocol (including the role of digital rectal examination [DRE] and prostate-specific antigen [PSA] measures) for people for whom active surveillance is appropriate, as assessed by multiparametric MRI and biopsy, when there are no clinical concerns during follow up?

For a short explanation of why the committee made the recommendation for research, see the rationale section on multiparametric MRI for active surveillance.

2 Follow up after radical treatment

What is the most clinically and cost-effective follow‑up protocol for people with prostate cancer who have had radical treatment, with specific regard to risk stratification, duration of follow up, frequency of follow‑up appointments, the type of examination or blood tests, and the roles of primary and secondary care in follow up?

For a short explanation of why the committee made the recommendation for research, see the rationale section on follow up.

3 Diagnosis of clinically significant cancer

What is the most clinically and cost-effective pathway for diagnosing clinically significant prostate cancer?

For a short explanation of why the committee made the recommendation for research, see the rationale section on MRI and biopsy.

4 Progression of cancer

What is the most clinically and cost-effective pathway for excluding the clinically significant progression of cancer in people with CPG 1, 2 and 3 prostate cancer?

For a short explanation of why the committee made the recommendation for research, see the rationale section on multiparametric MRI for active surveillance.

5 Natural history of prostate cancer

What is the natural history of people with a Likert score on MRI of less than 3 without biopsy at long-term follow up?

For a short explanation of why the committee made the recommendation for research, see the rationale section on MRI and biopsy.

Other recommendations for research

Staging investigations for CPG 3 prostate cancer

What is the diagnostic accuracy of staging investigations for CPG 3 prostate cancer?

For a short explanation of why the committee made the recommendation for research, see the rationale section on risk stratification for localised or locally advanced prostate cancer.

Full details of the evidence and the committee's discussion are in evidence review I: risk stratification for localised prostate cancer.

Diagnosing prostate cancer

In patients with negative MRI (Likert score 1 or 2), what is the next best diagnostic investigation to rule out clinically significant prostate cancer?

What is the diagnostic accuracy of transperineal mapping biopsy compared with transperineal non-mapping biopsy in the diagnosis of clinically significant prostate cancer?

Zoledronic acid

What is the effectiveness and cost effectiveness of different scheduling of zoledronic acid in the prevention and reduction of skeletal events in people with hormone-refractory prostate cancer?

  • National Institute for Health and Care Excellence (NICE)