Interpretation of the 2025 update to EUA prostate cancer guideline

CHENG Yongbing; QIU Xuefeng; GUO Hongqian

doi:10.3969/j.issn.1674-4136.2025.03.002

Abstract：The 2025 edition of the prostate cancer guidelines from the European Association of Urology(EAU)has been released as scheduled.This article deeply interprets the key updates of the new guidelines through integrating the 2024 edition and clinical practices at home and abroad.In terms of etiology and risk stratification,the new guideline has refined the definitions of familial and hereditary prostate cancer and reclassified the intermediate-risk prostate cancer subgroups.This improvement enhances the accuracy of disease risk assessment,laying a foundation for subsequent precise treatment.At the diagnostic level,the new guidelines emphasize the value of MRI combined with PSA screening and optimize the biopsy strategy,which significantly improves the diagnostic accuracy.Regarding treatment strategies,based on research results such as those from the TITAN and ARANOTE studies,the drug treatment regimen for metastatic hormone-sensitive prostate cancer has been updated.In terms of follow-up management,importance is attached to imaging monitoring,attention is paid to the long-term side effects of ADT,and therapies for preserving gonadal function are explored to improve the quality of life of patients.Overall,the new guidelines provide more detailed evidence-based references for the individualized and precise diagnosis and treatment of prostate cancer by refining the definition of genetic risks,strengthening the application of imaging,and optimizing treatment plans.The objectives of this article are to promote the integration of clinical practices in China with international guidelines,improve the standardization level of the whole-process management of prostate cancer,contribute to the development of prostate cancer diagnosis and treatment in China,and enable patients to benefit from it.