晚期前列腺癌患者的管理。 2024 年晚期前列腺癌共识会议 (APCCC) 的报告。
Management of Patients with Advanced Prostate Cancer. Report from the 2024 Advanced Prostate Cancer Consensus Conference (APCCC).
发表日期：2024 Oct 10
作者：
Silke Gillessen, Fabio Turco, Ian D Davis, Jason A Efstathiou, Karim Fizazi, Nicholas D James, Neal Shore, Eric Small, Matthew Smith, Christopher J Sweeney, Bertrand Tombal, Thomas Zilli, Neeraj Agarwal, Emmanuel S Antonarakis, Ana Aparicio, Andrew J Armstrong, Diogo Assed Bastos, Gerhardt Attard, Karol Axcrona, Mouna Ayadi, Himisha Beltran, Anders Bjartell, Pierre Blanchard, Maria T Bourlon, Alberto Briganti, Muhammad Bulbul, Consuelo Buttigliero, Orazio Caffo, Daniel Castellano, Elena Castro, Heather H Cheng, Kim N Chi, Caroline S Clarke, Noel Clarke, Johann S de Bono, Maria De Santis, Ignacio Duran, Eleni Efstathiou, Onyeanunam N Ekeke, Tamer I H El Nahas, Louise Emmett, Stefano Fanti, Omolara A Fatiregun, Felix Y Feng, Peter C C Fong, Valerie Fonteyne, Nicola Fossati, Daniel J George, Martin E Gleave, Gwenaelle Gravis, Susan Halabi, Daniel Heinrich, Ken Herrmann, Michael S Hofman, Thomas A Hope, Lisa G Horvath, Maha H A Hussain, Barbara Alicja Jereczek-Fossa, Robert J Jones, Anthony M Joshua, Ravindren Kanesvaran, Daniel Keizman, Raja B Khauli, Gero Kramer, Stacy Loeb, Brandon A Mahal, Fernando C Maluf, Joaquin Mateo, David Matheson, Mika P Matikainen, Ray McDermott, Rana R McKay, Niven Mehra, Axel S Merseburger, Alicia K Morgans, Michael J Morris, Hind Mrabti, Deborah Mukherji, Declan G Murphy, Vedang Murthy, Shingai B A Mutambirwa, Paul L Nguyen, William K Oh, Piet Ost, Joe M O'Sullivan, Anwar R Padhani, Chris Parker, Darren M C Poon, Colin C Pritchard, Danny M Rabah, Dana Rathkopf, Robert E Reiter, Raphaele Renard-Penna, Charles J Ryan, Fred Saad, Juan Pablo Sade, Shahneen Sandhu, Oliver A Sartor, Edward Schaeffer, Howard I Scher, Nima Sharifi, Iwona A Skoneczna, Howard R Soule, Daniel E Spratt, Sandy Srinivas, Cora N Sternberg, Hiroyoshi Suzuki, Mary-Ellen Taplin, Camilla Thellenberg-Karlsson, Derya Tilki, Levent N Türkeri, Hiroji Uemura, Yüksel Ürün, Claire L Vale, Neha Vapiwala, Jochen Walz, Kosj Yamoah, Dingwei Ye, Evan Y Yu, Almudena Zapatero, Aurelius Omlin
来源：
EUROPEAN UROLOGY
摘要：
创新改善了晚期前列腺癌 (PC) 的治疗效果。尽管如此，我们仍然缺乏对日常实践产生重大影响的各种主题的高级证据。 2024年晚期前列腺癌共识会议（APCCC）就临床管理的关键问题对专家进行了调查，以补充循证指南。在这里，我们展示了 APCCC 2024 问题的投票结果。在会议之前，由 120 名国际 PC 专家组成的小组使用修改后的 Delphi 流程针对 8 个不同主题制定了 183 个多项选择共识问题。在会议之前，这些问题通过基于网络的调查向投票小组成员（“小组成员”）进行管理。共识被预先定义为≥75％的同意，强烈共识被定义为≥90％的同意。投票结果显示了不同程度的共识，正如本文中所讨论的和补充材料中详细介绍的。这些发现不包括正式的文献综述或荟萃分析。投票结果可以帮助医生和患者应对临床管理中存在争议的领域，这些领域的高级证据缺乏或相互矛盾。研究结果还可以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特征进行个体化，并应纳入当前和新兴的临床证据、指南以及后勤和经济因素。始终强烈鼓励参加临床试验。重要的是，APCCC 2024 再次确定了值得在专门设计的试验中进行评估的重要差距（非共识领域）。版权所有 © 2024 作者。由 Elsevier B.V. 出版。保留所有权利。
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.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").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.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.Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.