Marra Giancarlo, Ploussard Guillaume, Ost Piet, De Visschere Pieter J L, Briganti Alberto, Gandaglia Giorgio, Tilki Derya, Surcel Christian I, Tsaur Igor, Van Den Bergh Roderick C N, Kretschmer Alexander, Borgmann Hendrik, Gontero Paolo, Ahmed Hashim U, Valerio Massimo
Department of Urology, San Giovanni Battista Hospital, Città della Salute e della Scienza and University of Turin, Turin, Italy.
Department of Urology, Saint Jean Languedoc Hospital and Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France.
Urol Oncol. 2018 Dec;36(12):529.e11-529.e22. doi: 10.1016/j.urolonc.2018.08.013. Epub 2018 Oct 6.
The urological community's opinion over focal therapy (FT) for prostate cancer (PCa) has never been assessed. Our aim was to investigate the current opinion on FT in the European urological community.
A 25-item questionnaire was devised according to the Cherries checklist and distributed through SurveyMonkey using a web link from November 2016 to October 2017. After a pilot validation (n = 40 urologists), the survey was sent through EAU and 9 other national European urological societies mailing list. Twitter was also used.
We received 484 replies from 51 countries. Almost half (44.8%, n = 217) stated FT would represent a step forward, and 52.0% (n = 252) would suggest FT to a patient. Almost three-quarters (70.8%, n = 343) agreed FT will become a standard option after improvements in patient selection (n = 66) or when its effectiveness will be proven (n = 78), or both (n = 199). Most frequently used definition of FT was treatment of all significant (life-threatening) cancer foci whilst leaving untreated the rest of the gland (39.3%, n = 190). FT use was considered as an alternative to whole-gland treatments by 29.7% (n = 144), and to AS by 25.0% (n = 121). On multivariate analysis, FT availability and publications were associated with a positive opinion on FT. Conversely, attending International congresses, treating high PCa volumes and high percentages of high-risk PCa was associated with a negative opinion.
FT is considered as an attractive option for PCa treatment by the European urological community sampled by our survey. FT availability positively influences these thoughts. The present survey suggests whilst some early adopters already embraced FT, the relative majority of the urological community is prone to embrace FT in the near future, once current areas of debate are solved.
泌尿外科界对前列腺癌（PCa）聚焦治疗（FT）的看法从未得到评估。我们的目的是调查欧洲泌尿外科界对FT的当前看法。
根据Cherries清单设计了一份包含25个条目的问卷，并于2016年11月至2017年10月通过SurveyMonkey使用网络链接进行分发。在进行了初步验证（40名泌尿外科医生）后，该调查通过欧洲泌尿外科学会（EAU）和其他9个欧洲国家泌尿外科协会的邮件列表发送。还使用了推特。
我们收到了来自51个国家的484份回复。近一半（44.8%，n = 217）表示FT将是向前迈出的一步，52.0%（n = 252）会向患者推荐FT。近四分之三（70.8%，n = 343）同意在患者选择得到改善（n = 66）或其有效性得到证实（n = 78），或两者都实现（n = 199）后，FT将成为一种标准选择。FT最常用的定义是治疗所有重要（危及生命）的癌灶，而其余腺体不进行治疗（39.3%，n = 190）。29.7%（n = 144）的人认为FT可作为全腺体治疗的替代方案，25.0%（n = 121）的人认为可替代主动监测（AS）。多因素分析显示，FT的可获得性和相关出版物与对FT的积极看法相关。相反，参加国际大会、治疗大量PCa患者以及高比例的高危PCa患者与消极看法相关。
在我们调查的欧洲泌尿外科界样本中，FT被认为是PCa治疗的一个有吸引力的选择。FT的可获得性对这些看法有积极影响。本次调查表明，虽然一些早期采用者已经接受了FT，但一旦当前的争议领域得到解决，泌尿外科界相对多数人在不久的将来倾向于接受FT。
