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Utilization of focal therapy for patients discontinuing active surveillance of prostate cancer: Recommendations of an international Delphi consensus.

Publication ,  Journal Article
Tan, WP; Rastinehad, AR; Klotz, L; Carroll, PR; Emberton, M; Feller, JF; George, AK; Gill, IS; Gupta, RT; Katz, AE; Lebastchi, AH; Marks, LS ...
Published in: Urol Oncol
November 2021

BACKGROUND: With the advancement of imaging technology, focal therapy (FT) has been gaining acceptance for the treatment of select patients with localized prostate cancer (CaP). We aim to provide details of a formal physician consensus on the utilization of FT for patients with CaP who are discontinuing active surveillance (AS). METHODS: A 3-stage Delphi consensus on CaP and FT was conducted. Consensus was defined as agreement by ≥80% of physicians. An in-person meeting was attended by 17 panelists to formulate the consensus statement. RESULTS: Fifty-six respondents participated in this interdisciplinary consensus study (82% urologist, 16% radiologist, 2% radiation oncology). The participants confirmed that there is a role for FT in men discontinuing AS (48% strongly agree, 39% agree). The benefit of FT over radical therapy for men coming off AS is: less invasive (91%), has a greater likelihood to preserve erectile function (91%), has a greater likelihood to preserve urinary continence (91%), has fewer side effects (86%), and has early recovery post-treatment (80%). Patients will need to undergo mpMRI of the prostate and/or a saturation biopsy to determine if they are potential candidates for FT. Our limitations include respondent's biases and that the participants of this consensus may not represent the larger medical community. CONCLUSIONS: FT can be offered to men coming off AS between the age of 60 to 80 with grade group 2 localized cancer. This consensus from a multidisciplinary, multi-institutional, international expert panel provides a contemporary insight utilizing FT for CaP in select patients who are discontinuing AS.

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Published In

Urol Oncol

DOI

EISSN

1873-2496

Publication Date

November 2021

Volume

39

Issue

11

Start / End Page

781.e17 / 781.e24

Location

United States

Related Subject Headings

  • Watchful Waiting
  • Urology & Nephrology
  • Prostatic Neoplasms
  • Middle Aged
  • Male
  • Humans
  • Delphi Technique
  • Consensus
  • Aged, 80 and over
  • Aged
 

Citation

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Tan, W. P., Rastinehad, A. R., Klotz, L., Carroll, P. R., Emberton, M., Feller, J. F., … Focal Therapy Group Authors, . (2021). Utilization of focal therapy for patients discontinuing active surveillance of prostate cancer: Recommendations of an international Delphi consensus. Urol Oncol, 39(11), 781.e17-781.e24. https://doi.org/10.1016/j.urolonc.2021.01.027
Tan, Wei Phin, Ardeshir R. Rastinehad, Laurence Klotz, Peter R. Carroll, Mark Emberton, John F. Feller, Arvin K. George, et al. “Utilization of focal therapy for patients discontinuing active surveillance of prostate cancer: Recommendations of an international Delphi consensus.Urol Oncol 39, no. 11 (November 2021): 781.e17-781.e24. https://doi.org/10.1016/j.urolonc.2021.01.027.
Tan WP, Rastinehad AR, Klotz L, Carroll PR, Emberton M, Feller JF, et al. Utilization of focal therapy for patients discontinuing active surveillance of prostate cancer: Recommendations of an international Delphi consensus. Urol Oncol. 2021 Nov;39(11):781.e17-781.e24.
Tan, Wei Phin, et al. “Utilization of focal therapy for patients discontinuing active surveillance of prostate cancer: Recommendations of an international Delphi consensus.Urol Oncol, vol. 39, no. 11, Nov. 2021, pp. 781.e17-781.e24. Pubmed, doi:10.1016/j.urolonc.2021.01.027.
Tan WP, Rastinehad AR, Klotz L, Carroll PR, Emberton M, Feller JF, George AK, Gill IS, Gupta RT, Katz AE, Lebastchi AH, Marks LS, Marra G, Pinto PA, Song DY, Sidana A, Ward JF, Sanchez-Salas R, Rosette JDL, Polascik TJ, Focal Therapy Group Authors. Utilization of focal therapy for patients discontinuing active surveillance of prostate cancer: Recommendations of an international Delphi consensus. Urol Oncol. 2021 Nov;39(11):781.e17-781.e24.
Journal cover image

Published In

Urol Oncol

DOI

EISSN

1873-2496

Publication Date

November 2021

Volume

39

Issue

11

Start / End Page

781.e17 / 781.e24

Location

United States

Related Subject Headings

  • Watchful Waiting
  • Urology & Nephrology
  • Prostatic Neoplasms
  • Middle Aged
  • Male
  • Humans
  • Delphi Technique
  • Consensus
  • Aged, 80 and over
  • Aged