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* (Corresponding Author), Steven MacLennan, Peter-Paul M. Willemse, Malcolm D. Mason, Karin Plass, Robert Shepherd

*Corresponding author for this work

Research output: Contribution to journalArticle

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, 3-phase study undertaken by the EAU-EANM-ESTRO-ESUR-SIOG Prostate Cancer Guideline Panel in conjunction with partner organisations, including: (1) A systematic review to describe heterogeneity across all domains; (2) A 2-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 consensus were strictly followed.
Results and limitations: 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 3 patients, where consensus was achieved in an 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 mpMRI 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 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 (i.e. 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
Early online date3 Oct 2019
DOIs
Publication statusPublished - 1 Dec 2019

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Prostatic Neoplasms
Consensus
Guidelines
Uncertainty
Delivery of Health Care
Therapeutics
Group Processes
Practice Guidelines
varespladib methyl
Patient Selection
Research Personnel
Outcome Assessment (Health Care)
Clinical Trials
Prospective Studies
Biopsy
Surveys and Questionnaires
Research

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

ASJC Scopus subject areas

  • Urology

Cite this

@article{c411626621174b66b11e9ab4186003d5,
title = "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)",
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, 3-phase study undertaken by the EAU-EANM-ESTRO-ESUR-SIOG Prostate Cancer Guideline Panel in conjunction with partner organisations, including: (1) A systematic review to describe heterogeneity across all domains; (2) A 2-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 consensus were strictly followed. Results and limitations: 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 3 patients, where consensus was achieved in an 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 mpMRI 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 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 (i.e. consensus) regarding best practice, which will provide guidance to clinicians and researchers.",
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",
author = "Lam, {Thomas B L} and Steven MacLennan and Willemse, {Peter-Paul M.} and Mason, {Malcolm D.} and Karin Plass and Robert Shepherd",
note = "The authors are grateful to the following individuals and organisations for the following contributions: R. Bryan Rumble, MSc for reviewing and commenting on the manuscript; American Society of Clinical Oncology (ASCO) for providing members who participated in the survey and consensus group meeting; IPSEN for providing an unrestricted educational grant; however IPSEN did not have any access to the study data nor did they have any control over the final manuscript; European Association of Urology (EAU) for providing an unrestricted educational grant; however the EAU did not have any access to the data nor did they have any control over the final manuscript.",
year = "2019",
month = "12",
day = "1",
doi = "10.1016/j.eururo.2019.09.020",
language = "English",
volume = "76",
pages = "790--813",
journal = "European Urology",
issn = "0302-2838",
publisher = "Elsevier",
number = "6",

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TY - JOUR

T1 - 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)

AU - Lam, Thomas B L

AU - MacLennan, Steven

AU - Willemse, Peter-Paul M.

AU - Mason, Malcolm D.

AU - Plass, Karin

AU - Shepherd, Robert

N1 - The authors are grateful to the following individuals and organisations for the following contributions: R. Bryan Rumble, MSc for reviewing and commenting on the manuscript; American Society of Clinical Oncology (ASCO) for providing members who participated in the survey and consensus group meeting; IPSEN for providing an unrestricted educational grant; however IPSEN did not have any access to the study data nor did they have any control over the final manuscript; European Association of Urology (EAU) for providing an unrestricted educational grant; however the EAU did not have any access to the data nor did they have any control over the final manuscript.

PY - 2019/12/1

Y1 - 2019/12/1

N2 - 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, 3-phase study undertaken by the EAU-EANM-ESTRO-ESUR-SIOG Prostate Cancer Guideline Panel in conjunction with partner organisations, including: (1) A systematic review to describe heterogeneity across all domains; (2) A 2-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 consensus were strictly followed. Results and limitations: 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 3 patients, where consensus was achieved in an 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 mpMRI 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 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 (i.e. consensus) regarding best practice, which will provide guidance to clinicians and researchers.

AB - 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, 3-phase study undertaken by the EAU-EANM-ESTRO-ESUR-SIOG Prostate Cancer Guideline Panel in conjunction with partner organisations, including: (1) A systematic review to describe heterogeneity across all domains; (2) A 2-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 consensus were strictly followed. Results and limitations: 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 3 patients, where consensus was achieved in an 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 mpMRI 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 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 (i.e. consensus) regarding best practice, which will provide guidance to clinicians and researchers.

KW - Deferred treatment with curative intent

KW - Active surveillance and monitoring

KW - Localised prostate cancer

KW - Eligibility

KW - Follow-up

KW - Reclassification

KW - Outcome measures

KW - Consensus statements

KW - Delphi survey

KW - Consensus group meeting

KW - Clinical practice guidelines

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U2 - 10.1016/j.eururo.2019.09.020

DO - 10.1016/j.eururo.2019.09.020

M3 - Article

VL - 76

SP - 790

EP - 813

JO - European Urology

JF - European Urology

SN - 0302-2838

IS - 6

ER -