Thomas B L Lam1, Steven MacLennan2, Peter-Paul M Willemse3, Malcolm D Mason4, Karin Plass5, Robert Shepherd5, Ruud Baanders6, Chris H Bangma7, Anders Bjartell8, Alberto Bossi9, Erik Briers10, Alberto Briganti11, Karel T Buddingh12, James W F Catto13, Maurizio Colecchia14, Brett W Cox15, Marcus G Cumberbatch16, Jeff Davies17, Niall F Davis18, Maria De Santis19, Paolo Dell'Oglio20, André Deschamps21, James F Donaldson22, Shin Egawa23, Christian D Fankhauser24, Stefano Fanti25, Nicola Fossati11, Giorgio Gandaglia26, Silke Gillessen27, Nikolaos Grivas28, Tobias Gross29, Jeremy P Grummet30, Ann M Henry31, Alexandre Ingels32, Jacques Irani33, Michael Lardas34, Matthew Liew35, Daniel W Lin36, Lisa Moris37, Muhammad Imran Omar2, Karl H Pang16, Catherine C Paterson38, Raphaële Renard-Penna39, Maria J Ribal40, Monique J Roobol7, Morgan Rouprêt41, Olivier Rouvière42, Gemma Sancho Pardo43, Jonathan Richenberg44, Ivo G Schoots45, J P Michiel Sedelaar46, Phillip Stricker47, Derya Tilki48, Susanne Vahr Lauridsen49, Roderick C N van den Bergh50, Thomas Van den Broeck51, Theodorus H van der Kwast52, Henk G van der Poel28, Geert J L H van Leenders52, Murali Varma53, Philippe D Violette54, Christopher J D Wallis55, Thomas Wiegel56, Karen Wilkinson57, Fabio Zattoni58, James M O N'Dow22, Hendrik Van Poppel51, Philip Cornford59, Nicolas Mottet60. 1. Academic Urology Unit, University of Aberdeen, Aberdeen, UK; Department of Urology, Aberdeen Royal Infirmary, Aberdeen, UK. Electronic address: thomas.lam@nhs.net. 2. Academic Urology Unit, University of Aberdeen, Aberdeen, UK. 3. Department of Urology, University Medical Center Utrecht, Utrecht, The Netherlands. 4. Division of Cancer and Genetics, School of Medicine Cardiff University, Velindre Cancer Centre, Cardiff, UK. 5. EAU Guidelines Office, Arnhem, The Netherlands. 6. Oxford, UK. 7. Department of Urology, Erasmus University Medical Centre, Rotterdam, The Netherlands. 8. Department of Urology, Skåne University Hospital Malmö, Lund University, Lund, Sweden. 9. Department of Radiation Oncology, Gustave Roussy Institute, Villejuif, France. 10. Hasselt, Belgium. 11. Department of Urology, Scientific Institute and University Vita-Salute San Raffaele Hospital, Milan, Italy. 12. HagaZiekenhuis, The Hague, The Netherlands. 13. Academic Urology Unit, University of Sheffield, Sheffield, UK; Department of Urology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK. 14. Uropathology Unit, Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy. 15. Department of Radiation Medicine, Zucker School of Medicine, Hempstead, New York, NY, USA. 16. Academic Urology Unit, University of Sheffield, Sheffield, UK. 17. Wales, UK. 18. Department of Urology, Beaumont and Connolly Hospitals, Dublin, Ireland; Royal College of Surgeons in Ireland, Dublin, Ireland. 19. Department of Urology, Charité University Hospital, Berlin, Germany. 20. Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy; ORSI Academy, Melle, Belgium. 21. Europa Uomo, Antwerp, Belgium. 22. Academic Urology Unit, University of Aberdeen, Aberdeen, UK; Department of Urology, Aberdeen Royal Infirmary, Aberdeen, UK. 23. Asian School of Urology, UAA, Jikei University School of Medicine, Tokyo, Japan. 24. Department of Urology, University of Zurich, Zurich, Switzerland. 25. Department of Nuclear Medicine, Policlinico S. Orsola, University of Bologna, Italy. 26. Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy. 27. Division of Cancer Sciences, University of Manchester and The Christie, Manchester, UK; Department of Medical Oncology and Haematology, Cantonal Hospital St. Gallen, University of Bern, Bern, Switzerland. 28. Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands. 29. Department of Urology, University of Bern, Bern, Switzerland. 30. Department of Surgery, Central Clinical School, Monash University, Melbourne, Australia. 31. Leeds Cancer Centre, St. James's University Hospital, Leeds, UK. 32. Department of Urology, Henri Mondor Hospital, Créteil, France. 33. University Hospital of Bicêtre-Paris Sud-Saclay University, Le Kremlin Bicêtre, France. 34. Department of Reconstructive Urology and Surgical Andrology, Metropolitan General, Athens, Greece. 35. Department of Urology, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK. 36. Cancer Prevention Program, Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA; Department of Urology, University of Washington, Seattle, WA, USA. 37. Department of Urology, University Hospitals Leuven, Leuven, Belgium; Laboratory of Molecular Endocrinology, KU Leuven, Leuven, Belgium. 38. Academic Urology Unit, University of Aberdeen, Aberdeen, UK; University of Canberra, School of Nursing, Midwifery and Public Health, Canberra, Australia; Robert Gordon University, School of Nursing and Midwifery, Aberdeen, UK. 39. Academic Department of Radiology, Sorbonne Université, GRC no 5, ONCOTYPE-URO, AP-HP, Hôpital Pitié-Salpêtrière-Hôpital Tenon, Paris, France. 40. Uro-Oncology Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain. 41. Urology Department, Sorbonne Université, GRC no 5, ONCOTYPE-URO, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France. 42. Hospices Civils de Lyon, Department of Urinary and Vascular Imaging, Hôpital Edouard Herriot, Lyon, France; Université de Lyon, Université Lyon 1, Faculté de Médecine Lyon Est, Lyon, France. 43. Department of Radiation Oncology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. 44. Royal Sussex County Hospital Brighton and Brighton and Sussex Medical School, Brighton, Sussex, UK. 45. Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands. 46. Department of Urology, Radboud University Medical Centre, Nijmegen, The Netherlands. 47. Department of Urology, St Vincents Hospital and Campus, Sydney, Australia; Garvan Institute of Research, Sydney, Australia. 48. Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany. 49. Department of Urology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. 50. Department of Urology, St. Antonius Hospital, Utrecht, The Netherlands. 51. Department of Urology, University Hospitals Leuven, Leuven, Belgium. 52. Department of Pathology, Erasmus University Medical Center, Rotterdam, The Netherlands. 53. Department of Cellular Pathology, University Hospital of Wales, Cardiff, UK. 54. Departments of Health Research Methods, Evidence and Impact (HEI) and Surgery, McMaster University, Hamilton, ON, Canada. 55. Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada; Department of Urology, Vanderbilt University Medical Center, Nashville, TN, USA. 56. Department of Radiation Oncology, University Hospital Ulm, Ulm, Germany. 57. University College London Hospitals, London, UK. 58. Urology Unit, Academic Medical Centre Hospital, Udine, Italy. 59. Royal Liverpool and Broadgreen Hospitals NHS Trust, Liverpool, UK. 60. Department of Urology, University Hospital Jean Monnet, St. Etienne, France.
Abstract
BACKGROUND: There is uncertainty in deferred active treatment (DAT) programmes, regarding patient selection, follow-up and monitoring, reclassification, and which outcome measures should be prioritised. OBJECTIVE: To develop consensus statements for all domains of DAT. DESIGN, SETTING, AND PARTICIPANTS: A protocol-driven, three phase study was undertaken by the European Association of Urology (EAU)-European Association of Nuclear Medicine (EANM)-European Society for Radiotherapy and Oncology (ESTRO)-European Association of Urology Section of Urological Research (ESUR)-International Society of Geriatric Oncology (SIOG) Prostate Cancer Guideline Panel in conjunction with partner organisations, including the following: (1) a systematic review to describe heterogeneity across all domains; (2) a two-round Delphi survey involving a large, international panel of stakeholders, including healthcare practitioners (HCPs) and patients; and (3) a consensus group meeting attended by stakeholder group representatives. Robust methods regarding what constituted the consensus were strictly followed. RESULTS AND LIMITATIONS: A total of 109 HCPs and 16 patients completed both survey rounds. Of 129 statements in the survey, consensus was achieved in 66 (51%); the rest of the statements were discussed and voted on in the consensus meeting by 32 HCPs and three patients, where consensus was achieved in additional 27 statements (43%). Overall, 93 statements (72%) achieved consensus in the project. Some uncertainties remained regarding clinically important thresholds for disease extent on biopsy in low-risk disease, and the role of multiparametric magnetic resonance imaging in determining disease stage and aggressiveness as a criterion for inclusion and exclusion. CONCLUSIONS: Consensus statements and the findings are expected to guide and inform routine clinical practice and research, until higher levels of evidence emerge through prospective comparative studies and clinical trials. PATIENT SUMMARY: We undertook a project aimed at standardising the elements of practice in active surveillance programmes for early localised prostate cancer because currently there is great variation and uncertainty regarding how best to conduct them. The project involved large numbers of healthcare practitioners and patients using a survey and face-to-face meeting, in order to achieve agreement (ie, consensus) regarding best practice, which will provide guidance to clinicians and researchers.
BACKGROUND: There is uncertainty in deferred active treatment (DAT) programmes, regarding patient selection, follow-up and monitoring, reclassification, and which outcome measures should be prioritised. OBJECTIVE: To develop consensus statements for all domains of DAT. DESIGN, SETTING, AND PARTICIPANTS: A protocol-driven, three phase study was undertaken by the European Association of Urology (EAU)-European Association of Nuclear Medicine (EANM)-European Society for Radiotherapy and Oncology (ESTRO)-European Association of Urology Section of Urological Research (ESUR)-International Society of Geriatric Oncology (SIOG) Prostate Cancer Guideline Panel in conjunction with partner organisations, including the following: (1) a systematic review to describe heterogeneity across all domains; (2) a two-round Delphi survey involving a large, international panel of stakeholders, including healthcare practitioners (HCPs) and patients; and (3) a consensus group meeting attended by stakeholder group representatives. Robust methods regarding what constituted the consensus were strictly followed. RESULTS AND LIMITATIONS: A total of 109 HCPs and 16 patients completed both survey rounds. Of 129 statements in the survey, consensus was achieved in 66 (51%); the rest of the statements were discussed and voted on in the consensus meeting by 32 HCPs and three patients, where consensus was achieved in additional 27 statements (43%). Overall, 93 statements (72%) achieved consensus in the project. Some uncertainties remained regarding clinically important thresholds for disease extent on biopsy in low-risk disease, and the role of multiparametric magnetic resonance imaging in determining disease stage and aggressiveness as a criterion for inclusion and exclusion. CONCLUSIONS: Consensus statements and the findings are expected to guide and inform routine clinical practice and research, until higher levels of evidence emerge through prospective comparative studies and clinical trials. PATIENT SUMMARY: We undertook a project aimed at standardising the elements of practice in active surveillance programmes for early localised prostate cancer because currently there is great variation and uncertainty regarding how best to conduct them. The project involved large numbers of healthcare practitioners and patients using a survey and face-to-face meeting, in order to achieve agreement (ie, consensus) regarding best practice, which will provide guidance to clinicians and researchers.
Authors: Ida Sonni; Ely R Felker; Andrew T Lenis; Anthony E Sisk; Shadfar Bahri; Martin Allen-Auerbach; Wesley R Armstrong; Voraparee Suvannarerg; Teeravut Tubtawee; Tristan Grogan; David Elashoff; Matthias Eiber; Steven S Raman; Johannes Czernin; Robert E Reiter; Jeremie Calais Journal: J Nucl Med Date: 2021-10-14 Impact factor: 11.082
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: Niklas Westhoff; Ramona Ernst; Karl Friedrich Kowalewski; Laura Schmidt; Thomas Stefan Worst; Maurice Stephan Michel; Jost von Hardenberg Journal: World J Urol Date: 2020-06-12 Impact factor: 4.226
Authors: Christian D Fankhauser; Benjamin E Ayres; Allaudin Issa; Maarten Albersen; Nick Watkin; Asif Muneer; Vijay Sangar; Arie Parnham Journal: Eur Urol Open Sci Date: 2021-01-07