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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).

Lam, Thomas B.L.; MacLennan, Steven; Willemse, Peter-Paul M.; Mason, Malcolm D.; Plass, Karin; Shepherd, Robert; Baanders, Ruud; Bangma, Chris H.; Bjartell, Anders; Bossi, Alberto; Briers, Erik; Briganti, Alberto; Buddingh, Karel T.; Catto, James W.F.; Colecchia, Maurizio; Cox, Brett W.; Cumberbatch, Marcus G.; Davies, Jeff; Davis, Niall F.; De Santis, Maria; Dell?Oglio, Paolo; Deschamps, Andr?; Donaldson, James F.; Egawa, Shin; Fankhauser, Christian D.; Fanti, Stefano; Fossati, Nicola; Gandaglia, Giorgio; Gillessen, Silke; Grivas, Nikolaos; Gross, Tobias; Grummet, Jeremy P.; Henry, Ann M.; Ingels, Alexandre; Irani, Jacques; Lardas, Michael; Liew, Matthew; Lin, Daniel W.; Moris, Lisa; Omar, Muhammad Imran; Pang, Karl H.; Paterson, Catherine C.; Renard-Penna, Rapha?le; Ribal, Maria J.; Roobol, Monique J.; Roupr?t, Morgan; Rouvi?re, Olivier; Sancho Pardo, Gemma; Richenberg, Jonathan; Schoots, Ivo G.; Sedelaar, J.P. Michiel; Stricker, Phillip; Tilki, Derya; Vahr Lauridsen, Susanne; van de...


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 Santis

Paolo Dell�Oglio

Andr� 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

Rapha�le Renard-Penna

Maria J. Ribal

Monique J. Roobol

Morgan Roupr�t

Olivier Rouvi�re

Gemma Sancho Pardo

Jonathan Richenberg

Ivo G. Schoots

J.P. Michiel Sedelaar

Phillip Stricker

Derya Tilki

Susanne Vahr Lauridsen

Roderick C.N. van den Bergh

Thomas Van den Broeck

Theodorus H. van der Kwast

Henk G. van der Poel

Geert J.L.H. van Leenders

Murali Varma

Philippe D. Violette

Christopher J.D. Wallis

Thomas Wiegel

Karen Wilkinson

Fabio Zattoni

James M.O. N�Dow

Hendrik Van Poppel

Philip Cornford

Nicolas Mottet


There is uncertainty in deferred active treatment (DAT) programmes, regarding patient selection, follow-up and monitoring, reclassification, and which outcome measures should be prioritised. To develop consensus statements for all domains of DAT. 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. 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. 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. 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.


LAM, T.B.L., MACLENNAN, S., WILLEMSE, P.-P.M. 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 [online], 76(6), pages 790-813. Available from:

Journal Article Type Article
Acceptance Date Sep 11, 2019
Online Publication Date Oct 3, 2019
Publication Date Dec 31, 2019
Deposit Date Nov 15, 2019
Publicly Available Date Oct 4, 2020
Journal European urology
Print ISSN 0302-2838
Electronic ISSN 1873-7560
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 76
Issue 6
Pages 790-813
Keywords Deferred treatment with curative intent; Active surveillance and monitoring; Localised prostate cancer; Eligibility; Follow-up; Reclassification; Outcome measures; Consensus statements; Delphi survey; Consensus group meeting; Clinical practice guidelines
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