Department of Radiation Oncology, UMCG, Groningen, The Netherlands.
Department of Medical Oncology, Radboudumc, Nijmegen, The Netherlands.
Eur Urol Oncol. 2020 Apr;3(2):231-238. doi: 10.1016/j.euo.2019.07.010. Epub 2019 Aug 8.
Oligometastatic prostate cancer (OMPC) is a heterogeneous disease state that is imperfectly understood, and its clinical implications are unclear.
To determine the consensus of a Dutch multidisciplinary expert panel on biological aspects, treatment goals, and management of OMPC in daily clinical practice.
DESIGN, SETTING, AND PARTICIPANTS: The study comprised a modified Delphi method including an explorative survey with various statements and questions, followed by a consensus meeting to discuss and determine the agreement with revised statements and related items. The panel consisted of 34 Dutch representatives from urology, medical and radiation oncology, radiology, nuclear medicine, and basic research.
Agreement was determined with statements (five-point scale). Consensus was defined as ≥75% panel agreement with a statement.
Consensus existed for 56% of statements. The panel agreed that OMPC comprises a limited metastatic spread in the hormone-sensitive setting, in both the synchronous and the metachronous presentation. Limited metastatic spread was believed to involve three to five metastases and a maximum of two organs. Prostate-specific membrane antigen positron emission tomography/computed tomography scan was currently perceived as the most accurate diagnostic imaging modality. Although there was a consensus that targeted treatment of all metastases in OMPC will delay further dissemination of the disease, opinions on specific treatment regimens were divided. Panel outcomes were limited by the lack of scientific evidence on OMPC.
A multidisciplinary panel reached a consensus that OMPC is a specific disease state requiring a tailored treatment approach. OMPC registries and clinical studies should focus on both the biology and the clinical parameters in relation to optimal treatment strategies in synchronous and metachronous OMPC.
A group of Dutch medical specialists agreed that prostate cancer patients having few metastases may benefit from a new therapeutic approach. Clinical studies need to determine which treatment is best for each specific situation.
寡转移前列腺癌（OMPC）是一种异质性疾病状态，目前尚未完全了解，其临床意义尚不清楚。
确定荷兰多学科专家小组对寡转移前列腺癌的生物学方面、治疗目标和日常临床实践管理的共识。
设计、设置和参与者：本研究采用改良 Delphi 方法，包括对各种陈述和问题进行探索性调查，然后进行共识会议，讨论并确定对经修订的陈述和相关项目的一致性。该小组由来自泌尿科、医学和放射肿瘤学、放射学、核医学和基础研究的 34 名荷兰代表组成。
通过（五分制）对陈述进行一致性判断。共识定义为≥75%的专家组对某一陈述达成一致。
56%的陈述达成了共识。专家组一致认为，寡转移前列腺癌在激素敏感的情况下，无论是同步还是异时表现，都局限于有限的转移扩散。有限的转移扩散被认为涉及三到五个转移灶，最多涉及两个器官。前列腺特异性膜抗原正电子发射断层扫描/计算机断层扫描目前被认为是最准确的诊断成像方式。虽然专家组一致认为，寡转移前列腺癌所有转移灶的靶向治疗将延迟疾病的进一步扩散，但对特定治疗方案的意见存在分歧。由于缺乏寡转移前列腺癌的科学证据，该研究结果存在局限性。
一个多学科小组达成了共识，即寡转移前列腺癌是一种需要量身定制治疗方法的特定疾病状态。寡转移前列腺癌登记处和临床研究应重点关注生物学和与同步和异时寡转移前列腺癌最佳治疗策略相关的临床参数。
一组荷兰医学专家认为，转移灶较少的前列腺癌患者可能受益于新的治疗方法。临床研究需要确定哪种治疗方法最适合每种特定情况。
