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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, André; 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, Raphaële; Ribal, Maria J.; Roobol, Monique J.; Rouprêt, Morgan; Rouvière, Olivier; Sancho Pardo, Gemma; Richenberg, Jonathan; Schoots, Ivo G.; Sedelaar, J.P. Michiel; Stricker, Phillip; Tilki, Derya; Vahr Lauridsen, Susanne; van den Bergh, Roderick C.N.; Van den Broeck, Thomas; van der Kwast, Theodorus H.; van der Poel, Henk G.; van Leenders, Geert J.L.H.; Varma, Murali; Violette, Philippe D.; Wallis, Christopher J.D.; Wiegel, Thomas; Wilkinson, Karen; Zattoni, Fabio; N’Dow, James M.O.; Van Poppel, Hendrik; Cornford, Philip; Mottet, Nicolas

Authors

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

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

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



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.

Journal Article Type Article
Publication Date Dec 31, 2019
Journal European Urology
Print ISSN 0302-2838
Electronic ISSN 1873-7560
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 76
Issue 6
Pages 790-813
Institution Citation 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., DE SANTIS, M., DELL'OGLIO, P., DESCHAMPS, A., DONALDSON, J.F., EGAWA, S., FANKHAUSER, C.D., FANTI, S., FOSSATI, N., GANDAGLIA, G., GILLESSEN, S., GRIVAS, N., GROSS, T., GRUMMET, J.P., HENRY, A.M., INGELS, A., IRANI, J., LARDAS, M., LIEW, M., LIN, D.W., MORIS, L., OMAR, M.I., PANG, K.H., PATERSON, C.C., RENARD-PENNA, R., RIBAL, M.J., ROOBOL, M.J., ROUPRÊT, M., ROUVIÉRE, O., PARDO, G.S., RICHENBERG, J., SCHOOTS, I.G., SEDELAAR, J.P.M., STRICKER, P., TILKI, D., VAHR LAURIDSEN, S., VAN DEN BERGH, R.C.N., VAN DEN BROECK, T., VAN DER KWAST, T.H., VAN DER POEL, H.G., VAN LEENDERS, G.J.L.H., VARMA, M., VIOLETTE, P.D., WALLIS, C.J.D., WIEGEL, T., WILKINSON, K., ZATTONI, F., N'DOW, J.M.O., VAN POPPEL, H., CORNFORD, P. and MOTTET, N. 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: https://doi.org/10.1016/j.eururo.2019.09.020
DOI https://doi.org/10.1016/j.eururo.2019.09.020
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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