{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T06:03:50Z","timestamp":1768284230614,"version":"3.49.0"},"reference-count":32,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T00:00:00Z","timestamp":1745539200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: The optimal diagnostic and therapeutic strategies for prostate cancer (PCa) in patients aged \u226575 years (mild-old and oldest-old) are still contentious. Resource allocation and ideal treatment for older patients are challenges, mainly due to their comorbidities and reduced life expectancy. This survey aims to assess current clinical practices and the experiences of healthcare providers in the diagnosis and management of elderly patients with PCa. Materials and Methods: In Northeast Italy, members of the Gruppo Uro-Oncologico del Nord-Est (GUONE) conducted a survey involving 104 physicians of different specialties (Nuclear Medicine, Medical Oncology, Radiation Oncology, Radiology, Urology) between 1 November 2024 and 30 November 2024. The survey encompassed 51 questions, evaluating various diagnostic and therapeutic scenarios. Results: Digital rectal exam (DRE) was recommended by 35.9% of physicians for patients aged 75 or older at risk of PCa. PSA testing was continued in 76.3% of these patients. For 36.5% of the physicians, there should be no age limit for prostate biopsy. Moreover, 42.6% of physicians recommended a magnetic resonance imaging (MRI)-guided prostate biopsy regardless of age. A prostate biopsy was deemed mandatory before initiating any form of hormonal therapy by 57.7% of the participants. For 22.3% and 34.7% of physicians, there should be no age limit for prostate MRI and PET\/CT for staging purposes. Interestingly, PET\/CT was not recommended in 52% of cases as a staging tool for patients older than 85 years. For patients without comorbidities, the age limit to consider radical prostatectomy (RP) was 75, with 58.6% of physicians in favor. There were no definitive limits for radiotherapy (RT). Chemotherapy had an age limit for 81.6% of the respondents; for 18.4%, 22.5%, and 26.5% of physicians, age limits were 75, 80, and 85 years, respectively. The use of androgen receptor pathway inhibitors (ARPIs) had no definitive age limits for 46.5% of respondents. For patients with no comorbidities and low-volume metastatic PCa, the preferred option was androgen deprivation therapy + ARPIs + RT. The follow-up schedule after RP or RT exhibited heterogeneity with no consensus regarding the frequency of PSA testing or the age at which it should be discontinued. Conclusions: This survey highlights the need for consensus guidelines in diagnosing and managing mild-old and oldest-old elderly PCa patients. With the aging population, standardized protocols are essential to ensure optimal care.<\/jats:p>","DOI":"10.3390\/diagnostics15091100","type":"journal-article","created":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T11:47:41Z","timestamp":1745581661000},"page":"1100","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prostate Cancer Diagnosis and Treatment in Elderly Patients: A Cross-Sectional Survey Exploring Practice Patterns and Preferences of Uro-Oncologists in Northeast Italy"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-1848-584X","authenticated-orcid":false,"given":"Filippo","family":"Carletti","sequence":"first","affiliation":[{"name":"Urology Clinic, Department of Surgery Oncology and Gastroenterology, University of Padua, 35122 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8021-9879","authenticated-orcid":false,"given":"Giuseppe","family":"Reitano","sequence":"additional","affiliation":[{"name":"Urology Clinic, Department of Surgery Oncology and Gastroenterology, University of Padua, 35122 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5955-9488","authenticated-orcid":false,"given":"Laura","family":"Evangelista","sequence":"additional","affiliation":[{"name":"Nuclear Medicine Unit, IRCCS Humanitas Research Hospital, 20089 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filippo","family":"Alongi","sequence":"additional","affiliation":[{"name":"Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, Negrar, 37024 Verona, Italy"},{"name":"Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Universit\u00e0 di Brescia, 25121 Brescia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Antonelli","sequence":"additional","affiliation":[{"name":"Urology Unit, University of Verona, 37129 Verona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5075-2177","authenticated-orcid":false,"given":"Umberto","family":"Basso","sequence":"additional","affiliation":[{"name":"Oncology Unit, Department of Oncology, Istituto Oncologico Veneto IOV-IRCCS, 35128 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Bortolus","sequence":"additional","affiliation":[{"name":"Radiation Oncology Department, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matteo","family":"Brunelli","sequence":"additional","affiliation":[{"name":"Pathology Unit, University of Verona, 37129 Verona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7968-2531","authenticated-orcid":false,"given":"Orazio","family":"Caffo","sequence":"additional","affiliation":[{"name":"Oncology Unit, Santa Chiara Hospital, 38122 Trento, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabrizio","family":"Dal Moro","sequence":"additional","affiliation":[{"name":"Urology Clinic, Department of Surgery Oncology and Gastroenterology, University of Padua, 35122 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rocco","family":"De Vivo","sequence":"additional","affiliation":[{"name":"Department of Oncology, Ospedale san Bartolo, 36100 Vicenza, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5923-9233","authenticated-orcid":false,"given":"Mario","family":"Gardi","sequence":"additional","affiliation":[{"name":"Urology Clinic, Department of Surgery Oncology and Gastroenterology, University of Padua, 35122 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rossano","family":"Girometti","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Udine, 33100 Udine, Italy"},{"name":"University Hospital S. Maria della Misericordia, ASUFC, 33100 Udine, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6609-7402","authenticated-orcid":false,"given":"Andrea","family":"Guttilla","sequence":"additional","affiliation":[{"name":"Urology Unit, ULSS 6 Euganea, 35012 Camposampiero, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2292-0444","authenticated-orcid":false,"given":"Fabio","family":"Matrone","sequence":"additional","affiliation":[{"name":"Radiation Oncology Department, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matteo","family":"Salgarello","sequence":"additional","affiliation":[{"name":"Nuclear Medicine Unit, IRCCS Ospedale Sacro Cuore Don Calabria, 37024 Negrar, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco Andrea","family":"Signor","sequence":"additional","affiliation":[{"name":"Radiation Therapy Unit, SMM University Hospital Udine, 33100 Udine, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4178-373X","authenticated-orcid":false,"given":"Fabio","family":"Zattoni","sequence":"additional","affiliation":[{"name":"Urology Clinic, Department of Surgery Oncology and Gastroenterology, University of Padua, 35122 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6995-246X","authenticated-orcid":false,"given":"Gianluca","family":"Giannarini","sequence":"additional","affiliation":[{"name":"Urology Unit, SMM University Hospital Udine, 33100 Udine, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"on behalf of Gruppo Uro-Oncologico del Nord Est (GUONE)","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1683","DOI":"10.1016\/S0140-6736(24)00651-2","article-title":"The Lancet Commission on prostate cancer: Planning for the surge in cases","volume":"403","author":"James","year":"2024","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"63","DOI":"10.14740\/wjon1191","article-title":"Epidemiology of Prostate Cancer","volume":"10","author":"Rawla","year":"2019","journal-title":"World J. 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