EAU-EANM-ESTRO-ESUR-SIOG Prostate Cancer Guideline Panel Consensus Statements for Deferred Treatment with Curative Intent for Localised Prostate Cancer from an International Collaborative Study (DETECTIVE Study)

Thomas B.L. Lam, Steven MacLennan, Peter Paul M. Willemse, Malcolm D. Mason, Karin Plass, Robert Shepherd, Ruud Baanders, Chris H. Bangma, Anders Bjartell, Alberto Bossi, Erik Briers, Alberto Briganti, Karel T. Buddingh, James W.F. Catto, Maurizio Colecchia, Brett W. Cox, Marcus G. Cumberbatch, Jeff Davies, Niall F. Davis, Maria De SantisPaolo Dell'Oglio, André Deschamps, James F. Donaldson, Shin Egawa, Christian D. Fankhauser, Stefano Fanti, Nicola Fossati, Giorgio Gandaglia, Silke Gillessen, Nikolaos Grivas, Tobias Gross, Jeremy P. Grummet, Ann M. Henry, Alexandre Ingels, Jacques Irani, Michael Lardas, Matthew Liew, Daniel W. Lin, Lisa Moris, Muhammad Imran Omar, Karl H. Pang, Catherine C. Paterson, Raphaële Renard-Penna, Maria J. Ribal, Monique J. Roobol, Morgan Rouprêt, Olivier Rouvière, Gemma Sancho Pardo, Jonathan Richenberg, Ivo G. Schoots

Research output: Contribution to journalReview article

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.

Original languageEnglish
Pages (from-to)790-813
Number of pages24
JournalEuropean Urology
Volume76
Issue number6
DOIs
Publication statusPublished - Dec 2019

Keywords

  • Active surveillance and monitoring
  • Clinical practice guidelines
  • Consensus group meeting
  • Consensus statements
  • Deferred treatment with curative intent
  • Delphi survey
  • Eligibility
  • Follow-up
  • Localised prostate cancer
  • Outcome measures
  • Reclassification

ASJC Scopus subject areas

  • Urology

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    Lam, T. B. L., MacLennan, S., Willemse, P. P. M., Mason, M. D., Plass, K., Shepherd, R., Baanders, R., Bangma, C. H., Bjartell, A., Bossi, A., Briers, E., Briganti, A., Buddingh, K. T., Catto, J. W. F., Colecchia, M., Cox, B. W., Cumberbatch, M. G., Davies, J., Davis, N. F., ... Schoots, I. G. (2019). EAU-EANM-ESTRO-ESUR-SIOG Prostate Cancer Guideline Panel Consensus Statements for Deferred Treatment with Curative Intent for Localised Prostate Cancer from an International Collaborative Study (DETECTIVE Study). European Urology, 76(6), 790-813. https://doi.org/10.1016/j.eururo.2019.09.020