Recommendations for follow up in castration resistant prostate cancer

OBJECTIVES: There is no broad consensus about what diagnostic tests use for CRPC follow up as well as their frequency. Our objective is to review and analyze the most important CRPC follow up patterns described in the literature to date. METHODS: We performed a critical analysis of the recommendations for follow up most universally employed (PCWG3, RADAR, St Gallen consensus, NCCN guidelines, EAU guidelines) RESULTS: CT scan and bone scan are the routine recommended diagnostic tests, in front of other techniques such as PET/CT or MRI, that may improve the diagnostic efficacy but they have the problem of availability and lack of internal validity for follow up. CONCLUSIONS: Follow up is different for non metastatic and metastatic CRPC. For nm CRPC, it is recommended to perform monitoring that includes PSA and imaging tests, without consensus about periodicity. For mCRPC, it is recammendable to do follow up with periodic PSA and imaging tests, since it is possible to have radiological progression without PSA progression.