Discrepancies Between Global Consensus and Local Implementation in the Management of Advanced Prostate Cancer

IF 4.5 3区医学 Q1 UROLOGY & NEPHROLOGY

European Urology Open Science Pub Date : 2026-03-01 Epub Date: 2026-02-19 DOI:10.1016/j.euros.2025.12.020

Niven Mehra , Daniela E. Oprea-Lager , Addy C.M. van de Luijtgaarden , Jochem R.N. van der Voort van Zyp , Shafak Aluwini , Herman J. Stoevelaar , Roderick C.N. van den Bergh

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Abstract

The biennial Advanced Prostate Cancer Consensus Conference (APCCC) provides expert-based recommendations on clinical topics for which high-level evidence is lacking. These consensus statements reflect the views of a worldwide panel of more than 100 specialists. There may be discrepancies in local implementation because of context-specific factors. To explore this for the Dutch situation, a national multidisciplinary panel of 34 specialists used a stepwise approach to evaluate selected APCCC 2024 questions. After individual voting, results were discussed in a plenary meeting with partial revoting. Discordance with APCCC consensus was observed for 35% of the questions. Items with the greatest disagreement were revisited in an online follow-up meeting. National deviations were largely regarded justified because of several contextual factors, including wider clinical adoption of prostate-specific membrane antigen positron emission tomography/computed tomography in the Netherlands. Our approach may provide an adequate means of identifying barriers for local compliance with the international consensus recommendations.

Patient summary

International experts established consensus statements on the treatment of advanced prostate cancer for topics with unclear evidence. Dutch specialists reviewed these recommendations to determine which ones fit best with local care.

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晚期前列腺癌管理的全球共识与局部实施的差异

两年一次的晚期前列腺癌共识会议（APCCC）就缺乏高水平证据的临床主题提供基于专家的建议。这些共识声明反映了一个由100多名专家组成的全球小组的观点。由于具体情况的因素，当地的执行可能存在差异。为了探讨荷兰的情况，一个由34名专家组成的国家多学科小组采用了逐步评估APCCC 2024选定问题的方法。个别表决结束后，在全体会议上进行部分表决。35%的问题与APCCC的共识不一致。分歧最大的项目在一次在线后续会议上重新讨论。由于几个背景因素，包括在荷兰更广泛的临床采用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，国家偏差在很大程度上被认为是合理的。我们的做法可能提供一种适当的手段，以确定当地遵守国际协商一致建议的障碍。患者总结：国际专家针对证据不明确的晚期前列腺癌的治疗建立了共识声明。荷兰专家审查了这些建议，以确定哪些建议最适合当地的护理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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