The Swedish national guidelines on prostate cancer: recurrent, metastatic and castration resistant disease
(2026) In Scandinavian Journal of Urology- Abstract (Swedish)
- Abstract
Objective: This article presents a summary of the 2025 Swedish prostate cancer guidelines, focusing on recurrence after local treatment, metastatic disease, and castration-resistant prostate cancer.
Results: The 2025 Swedish guidelines introduce several important updates. Prostate specific membrane antigen (PSMA)-PET/CT is recommended only when PSA exceeds 0.2 µg/L, and reporting should follow the defined PSMA-RADS-scale. PSMA-PET/CT is preferred over lymph-node dissection for staging. A strong recommendation is issued for radiotherapy to the primary tumour in all oligometastatic men with a life expectancy > 5 years, whereas metastasis-directed therapy is restricted to clinical trials. Systemic treatment pathways... (More) - Abstract
Objective: This article presents a summary of the 2025 Swedish prostate cancer guidelines, focusing on recurrence after local treatment, metastatic disease, and castration-resistant prostate cancer.
Results: The 2025 Swedish guidelines introduce several important updates. Prostate specific membrane antigen (PSMA)-PET/CT is recommended only when PSA exceeds 0.2 µg/L, and reporting should follow the defined PSMA-RADS-scale. PSMA-PET/CT is preferred over lymph-node dissection for staging. A strong recommendation is issued for radiotherapy to the primary tumour in all oligometastatic men with a life expectancy > 5 years, whereas metastasis-directed therapy is restricted to clinical trials. Systemic treatment pathways now prioritise androgen receptor pathway inhibitors (ARPI) plus androgen deprivation therapy (ADT), with triple therapy (including docetaxel) used more selectively. Pathway-specific staging algorithms have been revised. The oly (ADP-ribose) polymerase inhibitor (PARPi) section has expanded, with broader genomic-based selection and integration into treatment sequencing. Two new chapters and an appendix address cardiovascular risk assessment before ARPI or chemotherapy. Supportive care is substantially strengthened. Compared with the EAU-EANM-ESTRO-ESUR-ISUP-SIOG Guidelines on Prostate Cancer 2025, the Swedish guidelines 2025 applies PSMA-PET/CT more conservatively, restricts PSMA-guided nodal salvage therapy, and issues a more universal recommendation for local radiotherapy in oligometastatic disease. The Swedish guidelines 2025 prioritise ARPI + ADT and limit triple therapy and PARPi combinations due to regulatory and reimbursement constraints. PARPi are largely reserved for BRCA1/2-mutated disease. The Swedish guidelines 2025 provide a more comprehensive framework for rehabilitation and survivorship. (Less)
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- organization
- publishing date
- 2026-04-21
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Scandinavian Journal of Urology
- publisher
- Taylor & Francis
- external identifiers
-
- pmid:42012147
- scopus:105036254985
- ISSN
- 2168-1813
- DOI
- 10.2340/sju.v61.45715
- language
- Swedish
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- f210429c-a8b5-4c3c-bbb3-2cd549799d6d
- date added to LUP
- 2026-06-03 09:16:06
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@article{f210429c-a8b5-4c3c-bbb3-2cd549799d6d,
abstract = {{Abstract<br/>Objective: This article presents a summary of the 2025 Swedish prostate cancer guidelines, focusing on recurrence after local treatment, metastatic disease, and castration-resistant prostate cancer.<br/><br/>Results: The 2025 Swedish guidelines introduce several important updates. Prostate specific membrane antigen (PSMA)-PET/CT is recommended only when PSA exceeds 0.2 µg/L, and reporting should follow the defined PSMA-RADS-scale. PSMA-PET/CT is preferred over lymph-node dissection for staging. A strong recommendation is issued for radiotherapy to the primary tumour in all oligometastatic men with a life expectancy > 5 years, whereas metastasis-directed therapy is restricted to clinical trials. Systemic treatment pathways now prioritise androgen receptor pathway inhibitors (ARPI) plus androgen deprivation therapy (ADT), with triple therapy (including docetaxel) used more selectively. Pathway-specific staging algorithms have been revised. The oly (ADP-ribose) polymerase inhibitor (PARPi) section has expanded, with broader genomic-based selection and integration into treatment sequencing. Two new chapters and an appendix address cardiovascular risk assessment before ARPI or chemotherapy. Supportive care is substantially strengthened. Compared with the EAU-EANM-ESTRO-ESUR-ISUP-SIOG Guidelines on Prostate Cancer 2025, the Swedish guidelines 2025 applies PSMA-PET/CT more conservatively, restricts PSMA-guided nodal salvage therapy, and issues a more universal recommendation for local radiotherapy in oligometastatic disease. The Swedish guidelines 2025 prioritise ARPI + ADT and limit triple therapy and PARPi combinations due to regulatory and reimbursement constraints. PARPi are largely reserved for BRCA1/2-mutated disease. The Swedish guidelines 2025 provide a more comprehensive framework for rehabilitation and survivorship.}},
author = {{Johan, Stranne and Axén, Elin and Bratt, Ola and Carlsson, Stefan and Kindblom, Jon and Kohestani, Kimia and Lissbrant, Ingela Franck and Moise, Gabriel and Nemlander, Elinor and Robinsson, David and Torbrand, Christian and Wallström, Jonas and Wennerberg, Camilla and Thellenberg Karlsson, Camilla}},
issn = {{2168-1813}},
language = {{swe}},
month = {{04}},
publisher = {{Taylor & Francis}},
series = {{Scandinavian Journal of Urology}},
title = {{The Swedish national guidelines on prostate cancer: recurrent, metastatic and castration resistant disease}},
url = {{http://dx.doi.org/10.2340/sju.v61.45715}},
doi = {{10.2340/sju.v61.45715}},
year = {{2026}},
}