13 13 11 11 1 1 2 2 3 3 4 4 5 5 6 6 7 7 8 8 9 9 10 10 12 12 14 14 16 16 17 17 18 18 Metro Net: Prostate cancer Metro Net: Prostate cancer First signals First signals Surveillance Surveillance Initial local Initial local Follow up Follow up Restaging Restaging Surveillance Surveillance Local salvage Local salvage Follow up Follow up Restaging Restaging HSPC HSPC Restaging Restaging nmCRPC nmCRPC Start ADT Start ADT Restaging Restaging mCRPC1,2,3 mCRPC1,2,3 Restaging Restaging Diagnosis Diagnosis Active surveillance Active surveillance Watchfull waiting Watchfull waiting Radiotherapy Radiotherapy Radical prostatectomy Radical prostatectomy Active surveillance Active surveillance Watchfull waiting Watchfull waiting Salvage RT +/- RDT Salvage RT +/- RDT Radical prostatectomy Radical prostatectomy mHSPC mHSPC 15 15 ADT + Parp inhib. ADT + Parp inhib. ADT + Rad233 ADT + Rad233 ADT + ARSI/ARTA ADT + ARSI/ARTA ADT + Chemo ADT + Chemo ADT + Lutetium ADT + Lutetium Supportive Supportive ADT + Rad233 ADT + Rad233 ADT + ARSI/ARTA ADT + ARSI/ARTA ADT + Chemo ADT + Chemo ADT ADT ARSI/ARTA ARSI/ARTA Legend Legend Discussion with patient and planned SDM-moment. (possibility ... Discussion with patient and planned SDM-moment. (possibility to change path) Phase transfer: patient will continue path in another Metro l... Phase transfer: patient will continue path in another Metro line Treatment path of the patient Treatment path of the patient Transfer to other phase Transfer to other phase Repeating phase Repeating phase The goal of this Metro Map is to describe the curative part o... The goal of this Metro Map is to describe the curative part of the patient pathway from the early signs up to the end of the pathway. It is based on guidelines and analysis of the current situation.References:· European Association of Urology (2022) Prostate Cancer. https://uroweb.org/guideline/prostate-cancer. Accessed: April 2022. · Integraal Kankercentrum Nederland (2021). Oncoguide (Prostaatcarcinoom). https://oncoguide.nl/#!/projects/20/guideline. Accessed: April 2022. · Parker C.,Castro C., Fizazi K. Heidenreich A., Ost P, Procopio G., Tombal B. & Gillessen S. (2020). Prostate cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 30(p):1119-1134. https://doi.org/10.1016/j.annonc.2020.06.011 Colours Colours Orange: Trial Orange: Trial Lila: Follow up Lila: Follow up Dark blue: Proton therapy Dark blue: Proton therapy Green: Immunotherapy Green: Immunotherapy Blue green: Radiotherapy Blue green: Radiotherapy Fuchsia: Operation Fuchsia: Operation Light green: Chemotherapy Light green: Chemotherapy MM Blue: 3rd line diagnostics MM Blue: 3rd line diagnostics Sky blue: 2nd line diagnostics Sky blue: 2nd line diagnostics Gold: 1st line diagnostics Gold: 1st line diagnostics Team: Date: Version: 3.00 Team:Date: 28/03/2023Version:3.00 * The meaning of these colours are suggestions, you are free ... * The meaning of these colours are suggestions, you are free to change them if needed.