Jae Young Joung, In Gab Jeong, Sung Gu Kang, Young Hwii Ko, Kyo Chul Koo, Kwang Hyun Kim, Myung Ki Kim, Soodong Kim, Jeong Hyun Kim, Sung-Woo Park, Jae Young Park, Wan Song, Seung Hwan Lee, Seung Il Jung, Jae Hoon Chung, Chang Wook Jeong, Kwan Joong Joo, Seock Hwan Choi, Se Young Choi, Seol Ho Choo, Hong Koo Ha, Sung Kyu Hong, Sung-Hoo Hong, Jeong Hee Hong, Jun Hyuk Hong, Sun Il Kim, Cheol Kwak, Seong Soo Jeon
{"title":"在韩国建立转移性激素敏感性前列腺癌的共识建议:一项修改的德尔菲研究。","authors":"Jae Young Joung, In Gab Jeong, Sung Gu Kang, Young Hwii Ko, Kyo Chul Koo, Kwang Hyun Kim, Myung Ki Kim, Soodong Kim, Jeong Hyun Kim, Sung-Woo Park, Jae Young Park, Wan Song, Seung Hwan Lee, Seung Il Jung, Jae Hoon Chung, Chang Wook Jeong, Kwan Joong Joo, Seock Hwan Choi, Se Young Choi, Seol Ho Choo, Hong Koo Ha, Sung Kyu Hong, Sung-Hoo Hong, Jeong Hee Hong, Jun Hyuk Hong, Sun Il Kim, Cheol Kwak, Seong Soo Jeon","doi":"10.4111/icu.20250147","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Consensus is lacking among South Korean urologists on the appropriate treatment of metastatic hormone-sensitive prostate cancer (mHSPC). A modified, Delphi-based consensus on managing mHSPC patients was developed to support clinical decision-making.</p><p><strong>Materials and methods: </strong>Thirty-six questions on mHSPC treatment were developed by an expert committee (five urologists). Nine questions required achievement of consensus (key questions). Twenty-three urologists participated in two rounds of a Delphi survey. Consensus was defined as ≥75% agreement among panelists, with ≥90% agreement representing strong consensus.</p><p><strong>Results: </strong>Eighteen questions (50.0%) reached strong consensus, 15 (41.7%) reached consensus, and three (8.3%) reached no consensus. Eight key questions (88.9%) reached strong consensus and one (11.1%) reached consensus. Consensus was reached on recommending androgen-deprivation therapy (ADT) intensification, irrespective of disease volume or type, with an androgen receptor pathway inhibitor (ARPI) as the preferred option. Not using docetaxel alone with ADT when an ARPI is available for treatment intensification was recommended (strong consensus). For high-volume mHSPC patients with a pathogenic, speckle-type poxvirus and zinc finger protein mutation, ADT+ARPI was recommended over triplet therapy (strong consensus). Panelists recommended regular imaging every 6-12 months if no ARPI reimbursement restrictions exist, but a 3-month interval (per current reimbursement guidelines) otherwise. ADT+ARPI was the most recommended systemic treatment (strong consensus).</p><p><strong>Conclusions: </strong>This Delphi consensus established local consensus on controversial areas of mHSPC management. The findings offer meaningful perspectives that may help shape future treatment strategies and encourage thoughtful reconsideration of reimbursement criteria to align evidence and clinical practice in South Korea.</p>","PeriodicalId":14522,"journal":{"name":"Investigative and Clinical Urology","volume":"66 5","pages":"416-430"},"PeriodicalIF":2.1000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12437568/pdf/","citationCount":"0","resultStr":"{\"title\":\"Establishing consensus recommendations for metastatic hormone-sensitive prostate cancer in South Korea: A modified Delphi study.\",\"authors\":\"Jae Young Joung, In Gab Jeong, Sung Gu Kang, Young Hwii Ko, Kyo Chul Koo, Kwang Hyun Kim, Myung Ki Kim, Soodong Kim, Jeong Hyun Kim, Sung-Woo Park, Jae Young Park, Wan Song, Seung Hwan Lee, Seung Il Jung, Jae Hoon Chung, Chang Wook Jeong, Kwan Joong Joo, Seock Hwan Choi, Se Young Choi, Seol Ho Choo, Hong Koo Ha, Sung Kyu Hong, Sung-Hoo Hong, Jeong Hee Hong, Jun Hyuk Hong, Sun Il Kim, Cheol Kwak, Seong Soo Jeon\",\"doi\":\"10.4111/icu.20250147\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Consensus is lacking among South Korean urologists on the appropriate treatment of metastatic hormone-sensitive prostate cancer (mHSPC). A modified, Delphi-based consensus on managing mHSPC patients was developed to support clinical decision-making.</p><p><strong>Materials and methods: </strong>Thirty-six questions on mHSPC treatment were developed by an expert committee (five urologists). Nine questions required achievement of consensus (key questions). Twenty-three urologists participated in two rounds of a Delphi survey. Consensus was defined as ≥75% agreement among panelists, with ≥90% agreement representing strong consensus.</p><p><strong>Results: </strong>Eighteen questions (50.0%) reached strong consensus, 15 (41.7%) reached consensus, and three (8.3%) reached no consensus. Eight key questions (88.9%) reached strong consensus and one (11.1%) reached consensus. Consensus was reached on recommending androgen-deprivation therapy (ADT) intensification, irrespective of disease volume or type, with an androgen receptor pathway inhibitor (ARPI) as the preferred option. Not using docetaxel alone with ADT when an ARPI is available for treatment intensification was recommended (strong consensus). For high-volume mHSPC patients with a pathogenic, speckle-type poxvirus and zinc finger protein mutation, ADT+ARPI was recommended over triplet therapy (strong consensus). Panelists recommended regular imaging every 6-12 months if no ARPI reimbursement restrictions exist, but a 3-month interval (per current reimbursement guidelines) otherwise. ADT+ARPI was the most recommended systemic treatment (strong consensus).</p><p><strong>Conclusions: </strong>This Delphi consensus established local consensus on controversial areas of mHSPC management. 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Establishing consensus recommendations for metastatic hormone-sensitive prostate cancer in South Korea: A modified Delphi study.
Purpose: Consensus is lacking among South Korean urologists on the appropriate treatment of metastatic hormone-sensitive prostate cancer (mHSPC). A modified, Delphi-based consensus on managing mHSPC patients was developed to support clinical decision-making.
Materials and methods: Thirty-six questions on mHSPC treatment were developed by an expert committee (five urologists). Nine questions required achievement of consensus (key questions). Twenty-three urologists participated in two rounds of a Delphi survey. Consensus was defined as ≥75% agreement among panelists, with ≥90% agreement representing strong consensus.
Results: Eighteen questions (50.0%) reached strong consensus, 15 (41.7%) reached consensus, and three (8.3%) reached no consensus. Eight key questions (88.9%) reached strong consensus and one (11.1%) reached consensus. Consensus was reached on recommending androgen-deprivation therapy (ADT) intensification, irrespective of disease volume or type, with an androgen receptor pathway inhibitor (ARPI) as the preferred option. Not using docetaxel alone with ADT when an ARPI is available for treatment intensification was recommended (strong consensus). For high-volume mHSPC patients with a pathogenic, speckle-type poxvirus and zinc finger protein mutation, ADT+ARPI was recommended over triplet therapy (strong consensus). Panelists recommended regular imaging every 6-12 months if no ARPI reimbursement restrictions exist, but a 3-month interval (per current reimbursement guidelines) otherwise. ADT+ARPI was the most recommended systemic treatment (strong consensus).
Conclusions: This Delphi consensus established local consensus on controversial areas of mHSPC management. The findings offer meaningful perspectives that may help shape future treatment strategies and encourage thoughtful reconsideration of reimbursement criteria to align evidence and clinical practice in South Korea.
期刊介绍:
Investigative and Clinical Urology (Investig Clin Urol, ICUrology) is an international, peer-reviewed, platinum open access journal published bimonthly. ICUrology aims to provide outstanding scientific and clinical research articles, that will advance knowledge and understanding of urological diseases and current therapeutic treatments. ICUrology publishes Original Articles, Rapid Communications, Review Articles, Special Articles, Innovations in Urology, Editorials, and Letters to the Editor, with a focus on the following areas of expertise:
• Precision Medicine in Urology
• Urological Oncology
• Robotics/Laparoscopy
• Endourology/Urolithiasis
• Lower Urinary Tract Dysfunction
• Female Urology
• Sexual Dysfunction/Infertility
• Infection/Inflammation
• Reconstruction/Transplantation
• Geriatric Urology
• Pediatric Urology
• Basic/Translational Research
One of the notable features of ICUrology is the application of multimedia platforms facilitating easy-to-access online video clips of newly developed surgical techniques from the journal''s website, by a QR (quick response) code located in the article, or via YouTube. ICUrology provides current and highly relevant knowledge to a broad audience at the cutting edge of urological research and clinical practice.