Facharzt FMH Urologie Practice Questions - Facharzt FMH Für Urologie Spécialiste FMH En Urologie Exam

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A 58-year-old asymptomatic man is diagnosed with prostate adenocarcinoma following a combined MRI-targeted and systematic biopsy. Pathology confirms ISUP Grade Group 1 (Gleason score 3+3=6) in 2 out of 14 cores, with a maximum core involvement of 30%. His PSA is 4.8 ng/mL, prostate volume is 45 mL (PSA density 0.11 ng/mL/cc), and digital rectal examination is normal (cT1c). According to EAU guidelines, what is the preferred initial management strategy?

Immediate robotic-assisted laparoscopic radical prostatectomy with bilateral pelvic lymphadenectomy Active surveillance with scheduled PSA monitoring, repeat mpMRI, and confirmatory/surveillance biopsies External beam radiation therapy with 18 months of androgen deprivation therapy High-intensity focused ultrasound (HIFU) hemiablation of the prostate gland

Correct Answer:

Active surveillance with scheduled PSA monitoring, repeat mpMRI, and confirmatory/surveillance biopsies

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