BACKGROUND: Oligometastatic prostate cancer (OMPC) is a heterogeneous disease state that is imperfectly understood, and its clinical implications are unclear. OBJECTIVE: To determine the consensus of a Dutch multidisciplinary expert panel on biological aspects, treatment goals, and management of OMPC in daily clinical practice. DESIGN, SETTING, AND PARTICIPANTS: The study comprised a modified Delphi method including an explorative survey with various statements and questions, followed by a consensus meeting to discuss and determine the agreement with revised statements and related items. The panel consisted of 34 Dutch representatives from urology, medical and radiation oncology, radiology, nuclear medicine, and basic research. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Agreement was determined with statements (five-point scale). Consensus was defined as ≥75% panel agreement with a statement. RESULTS AND LIMITATIONS: Consensus existed for 56% of statements. The panel agreed that OMPC comprises a limited metastatic spread in the hormone-sensitive setting, in both the synchronous and the metachronous presentation. Limited metastatic spread was believed to involve three to five metastases and a maximum of two organs. Prostate-specific membrane antigen positron emission tomography/computed tomography scan was currently perceived as the most accurate diagnostic imaging modality. Although there was a consensus that targeted treatment of all metastases in OMPC will delay further dissemination of the disease, opinions on specific treatment regimens were divided. Panel outcomes were limited by the lack of scientific evidence on OMPC. CONCLUSIONS: A multidisciplinary panel reached a consensus that OMPC is a specific disease state requiring a tailored treatment approach. OMPC registries and clinical studies should focus on both the biology and the clinical parameters in relation to optimal treatment strategies in synchronous and metachronous OMPC. PATIENT SUMMARY: A group of Dutch medical specialists agreed that prostate cancer patients having few metastases may benefit from a new therapeutic approach. Clinical studies need to determine which treatment is best for each specific situation.
BACKGROUND:Oligometastatic prostate cancer (OMPC) is a heterogeneous disease state that is imperfectly understood, and its clinical implications are unclear. OBJECTIVE: To determine the consensus of a Dutch multidisciplinary expert panel on biological aspects, treatment goals, and management of OMPC in daily clinical practice. DESIGN, SETTING, AND PARTICIPANTS: The study comprised a modified Delphi method including an explorative survey with various statements and questions, followed by a consensus meeting to discuss and determine the agreement with revised statements and related items. The panel consisted of 34 Dutch representatives from urology, medical and radiation oncology, radiology, nuclear medicine, and basic research. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Agreement was determined with statements (five-point scale). Consensus was defined as ≥75% panel agreement with a statement. RESULTS AND LIMITATIONS: Consensus existed for 56% of statements. The panel agreed that OMPC comprises a limited metastatic spread in the hormone-sensitive setting, in both the synchronous and the metachronous presentation. Limited metastatic spread was believed to involve three to five metastases and a maximum of two organs. Prostate-specific membrane antigen positron emission tomography/computed tomography scan was currently perceived as the most accurate diagnostic imaging modality. Although there was a consensus that targeted treatment of all metastases in OMPC will delay further dissemination of the disease, opinions on specific treatment regimens were divided. Panel outcomes were limited by the lack of scientific evidence on OMPC. CONCLUSIONS: A multidisciplinary panel reached a consensus that OMPC is a specific disease state requiring a tailored treatment approach. OMPC registries and clinical studies should focus on both the biology and the clinical parameters in relation to optimal treatment strategies in synchronous and metachronous OMPC. PATIENT SUMMARY: A group of Dutch medical specialists agreed that prostate cancerpatients having few metastases may benefit from a new therapeutic approach. Clinical studies need to determine which treatment is best for each specific situation.
Authors: Jiun-Hung Geng; Anna Plym; Kathryn L Penney; Mark Pomerantz; Lorelei A Mucci; Adam S Kibel Journal: Prostate Cancer Prostatic Dis Date: 2022-01-24 Impact factor: 5.554
Authors: Hossein Jadvar; Jeremie Calais; Stefano Fanti; Felix Feng; Kirsten L Greene; James L Gulley; Michael Hofman; Bridget F Koontz; Daniel W Lin; Michael J Morris; Steve P Rowe; Trevor J Royce; Simpa Salami; Bital Savir-Baruch; Sandy Srinivas; Thomas A Hope Journal: J Nucl Med Date: 2021-09-30 Impact factor: 11.082
Authors: Carlo A Bravi; Nicola Fossati; Giorgio Gandaglia; Nazareno Suardi; Elio Mazzone; Daniele Robesti; Daniar Osmonov; Klaus-Peter Juenemann; Luca Boeri; R Jeffrey Karnes; Alexander Kretschmer; Alexander Buchner; Christian Stief; Andreas Hiester; Alessandro Nini; Peter Albers; Gaëtan Devos; Steven Joniau; Hendrik Van Poppel; Shahrokh F Shariat; Axel Heidenreich; David Pfister; Derya Tilki; Markus Graefen; Inderbir S Gill; Alexander Mottrie; Pierre I Karakiewicz; Francesco Montorsi; Alberto Briganti Journal: Eur Urol Date: 2020-07-02 Impact factor: 24.267
Authors: Gennady Bratslavsky; Neil Mendhiratta; Michael Daneshvar; James Brugarolas; Mark W Ball; Adam Metwalli; Katherine L Nathanson; Phillip M Pierorazio; Ronald S Boris; Eric A Singer; Maria I Carlo; Mary B Daly; Elizabeth P Henske; Colette Hyatt; Lindsay Middleton; Gloria Morris; Anhyo Jeong; Vivek Narayan; W Kimryn Rathmell; Ulka Vaishampayan; Bruce H Lee; Dena Battle; Michael J Hall; Khaled Hafez; Michael A S Jewett; Christina Karamboulas; Sumanta K Pal; A Ari Hakimi; Alexander Kutikov; Othon Iliopoulos; W Marston Linehan; Eric Jonasch; Ramaprasad Srinivasan; Brian Shuch Journal: Cancer Date: 2021-08-03 Impact factor: 6.860
Authors: Bastiaan M Privé; Marcel J R Janssen; Inge M van Oort; Constantijn H J Muselaers; Marianne A Jonker; Michel de Groot; Niven Mehra; J Fred Verzijlbergen; Tom W J Scheenen; Patrik Zámecnik; Jelle O Barentsz; Martin Gotthardt; Walter Noordzij; Wouter V Vogel; Andries M Bergman; Henk G van der Poel; André N Vis; Daniela E Oprea-Lager; Winald R Gerritsen; J Alfred Witjes; James Nagarajah Journal: BMC Cancer Date: 2020-09-14 Impact factor: 4.430
Authors: Charlotte L Deijen; Gerbert L Vrijenhoek; Eva E Schaake; Wouter V Vogel; Luc M F Moonen; Floris J Pos; Henk G van der Poel; Gerben R Borst Journal: Clin Transl Radiat Oncol Date: 2021-06-29