Editing AUA: Advanced Prostate Cancer (2023) (section)

=== <span style="color:#ff0000">Diagnosis and Evaluation</span> ===
*'''<span style="color:#ff0000">History and Physical Exam</span>'''
** '''<span style="color:#ff0000">Presence of symptoms from metastatic disease</span>'''
*** Symptoms in mHSPC have been shown to have prognostic value.
* '''<span style="color:#ff0000">Imaging</span>'''
** '''<span style="color:#ff0000">Assess the extent of metastatic disease (lymph node, bone, and visceral metastasis) in newly diagnosed mHSPC</span>'''
*** Extent of metastatic disease influences response.
*** '''<span style="color:#ff0000">CHAARTED definition of high-volume vs. low-volume</span>'''
**** '''<span style="color:#ff0000">High-volume:</span>'''
***** '''<span style="color:#ff0000">Visceral metastasis or</span>'''
***** '''<span style="color:#ff0000">≥4 bone metastases with ≥ 1 beyond the vertebral bodies and pelvis</span>'''
**** '''<span style="color:#ff0000">Low-volume: all others</span>'''
*** '''<span style="color:#ff0000">LATITUDE definition of high-risk vs. low-risk</span>'''
**** '''<span style="color:#ff0000">High-risk: ≥2 of the following 3 criteria:</span>'''
****# '''<span style="color:#ff0000">Visceral metastases</span>'''
****# '''<span style="color:#ff0000">≥ 3 bony metastases</span>'''
****# '''<span style="color:#ff0000">Gleason score ≥ 8</span>'''
**** LATITUDE excluded patients with “Low-risk” disease
* '''<span style="color:#ff0000">Genetic testing</span>'''
**'''<span style="color:#ff0000">Offer germline testing</span>'''
**'''<span style="color:#ff0000">Consider somatic testing and genetic counseling</span>'''