晚期前列腺癌患者的管理。2024年晚期前列腺癌共识会议（APCCC）报告。
Management of Patients with Advanced Prostate Cancer. Report from the 2024 Advanced Prostate Cancer Consensus Conference (APCCC).
作者信息
Gillessen Silke, Turco Fabio, Davis Ian D, Efstathiou Jason A, Fizazi Karim, James Nicholas D, Shore Neal, Small Eric, Smith Matthew, Sweeney Christopher J, Tombal Bertrand, Zilli Thomas, Agarwal Neeraj, Antonarakis Emmanuel S, Aparicio Ana, Armstrong Andrew J, Bastos Diogo Assed, Attard Gerhardt, Axcrona Karol, Ayadi Mouna, Beltran Himisha, Bjartell Anders, Blanchard Pierre, Bourlon Maria T, Briganti Alberto, Bulbul Muhammad, Buttigliero Consuelo, Caffo Orazio, Castellano Daniel, Castro Elena, Cheng Heather H, Chi Kim N, Clarke Caroline S, Clarke Noel, de Bono Johann S, De Santis Maria, Duran Ignacio, Efstathiou Eleni, Ekeke Onyeanunam N, El Nahas Tamer I H, Emmett Louise, Fanti Stefano, Fatiregun Omolara A, Feng Felix Y, Fong Peter C C, Fonteyne Valerie, Fossati Nicola, George Daniel J, Gleave Martin E, Gravis Gwenaelle, Halabi Susan, Heinrich Daniel, Herrmann Ken, Hofman Michael S, Hope Thomas A, Horvath Lisa G, Hussain Maha H A, Jereczek-Fossa Barbara Alicja, Jones Robert J, Joshua Anthony M, Kanesvaran Ravindren, Keizman Daniel, Khauli Raja B, Kramer Gero, Loeb Stacy, Mahal Brandon A, Maluf Fernando C, Mateo Joaquin, Matheson David, Matikainen Mika P, McDermott Ray, McKay Rana R, Mehra Niven, Merseburger Axel S, Morgans Alicia K, Morris Michael J, Mrabti Hind, Mukherji Deborah, Murphy Declan G, Murthy Vedang, Mutambirwa Shingai B A, Nguyen Paul L, Oh William K, Ost Piet, O'Sullivan Joe M, Padhani Anwar R, Parker Chris, Poon Darren M C, Pritchard Colin C, Rabah Danny M, Rathkopf Dana, Reiter Robert E, Renard-Penna Raphaele, Ryan Charles J, Saad Fred, Sade Juan Pablo, Sandhu Shahneen, Sartor Oliver A, Schaeffer Edward, Scher Howard I, Sharifi Nima, Skoneczna Iwona A, Soule Howard R, Spratt Daniel E, Srinivas Sandy, Sternberg Cora N, Suzuki Hiroyoshi, Taplin Mary-Ellen, Thellenberg-Karlsson Camilla, Tilki Derya, Türkeri Levent N, Uemura Hiroji, Ürün Yüksel, Vale Claire L, Vapiwala Neha, Walz Jochen, Yamoah Kosj, Ye Dingwei, Yu Evan Y, Zapatero Almudena, Omlin Aurelius
机构信息
Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland; Faculty of Biosciences, Università della Svizzera Italiana, Lugano, Switzerland.
Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.
出版信息
Eur Urol. 2025 Feb;87(2):157-216. doi: 10.1016/j.eururo.2024.09.017. Epub 2024 Oct 11.
BACKGROUND AND OBJECTIVE
Innovations have improved outcomes in advanced prostate cancer (PC). Nonetheless, we continue to lack high-level evidence on a variety of topics that greatly impact daily practice. The 2024 Advanced Prostate Cancer Consensus Conference (APCCC) surveyed experts on key questions in clinical management in order to supplement evidence-based guidelines. Here we present voting results for questions from APCCC 2024.
METHODS
Before the conference, a panel of 120 international PC experts used a modified Delphi process to develop 183 multiple-choice consensus questions on eight different topics. Before the conference, these questions were administered via a web-based survey to the voting panel members ("panellists").
KEY FINDINGS AND LIMITATIONS
Consensus was a priori defined as ≥75% agreement, with strong consensus defined as ≥90% agreement. The voting results show varying degrees of consensus, as discussed in this article and detailed in the Supplementary material. These findings do not include a formal literature review or meta-analysis.
CONCLUSIONS AND CLINICAL IMPLICATIONS
The voting results can help physicians and patients navigate controversial areas of clinical management for which high-level evidence is scant or conflicting. The findings can also help funders and policymakers in prioritising areas for future research. Diagnostic and treatment decisions should always be individualised on the basis of patient and cancer characteristics, and should incorporate current and emerging clinical evidence, guidelines, and logistic and economic factors. Enrolment in clinical trials is always strongly encouraged. Importantly, APCCC 2024 once again identified important gaps (areas of nonconsensus) that merit evaluation in specifically designed trials.
背景与目的
创新已改善了晚期前列腺癌（PC）的治疗结果。尽管如此，我们在许多对日常临床实践有重大影响的主题上仍缺乏高级别证据。2024年晚期前列腺癌共识会议（APCCC）就临床管理中的关键问题对专家进行了调查，以补充循证指南。在此，我们展示APCCC 2024相关问题的投票结果。
方法
会议召开前，由120名国际前列腺癌专家组成的小组采用改良德尔菲法，就八个不同主题拟定了183道多项选择的共识问题。会议召开前，这些问题通过网络调查的方式发给投票小组成员（“专家小组成员”）。
主要发现与局限性
共识事先被定义为≥75%的同意率，强烈共识被定义为≥90%的同意率。投票结果显示出不同程度的共识，如本文所讨论并在补充材料中详细说明的那样。这些发现未包括正式的文献综述或荟萃分析。
结论与临床意义
投票结果可帮助医生和患者在临床管理中存在争议、高级别证据稀少或相互矛盾的领域做出决策。这些发现还可帮助资助者和政策制定者确定未来研究的优先领域。诊断和治疗决策应始终根据患者和癌症的特征进行个体化，并应纳入当前和新出现的临床证据、指南以及后勤和经济因素。始终强烈鼓励患者参加临床试验。重要的是，APCCC 2024再次确定了一些重要差距（未达成共识的领域），值得在专门设计的试验中进行评估。
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