Transatlantic Consensus Group on active surveillance and focal therapy for prostate cancer Journal Article
| Authors: | Ahmed, H. U.; Akin, O.; Coleman, J. A.; Crane, S.; Emberton, M.; Goldenberg, L.; Hricak, H.; Kattan, M. W.; Kurhanewicz, J.; Moore, C. M.; Parker, C.; Polascik, T. J.; Scardino, P.; Van As, N.; Villers, A. |
| Article Title: | Transatlantic Consensus Group on active surveillance and focal therapy for prostate cancer |
| Abstract: | OBJECTIVE • To reach consensus on key issues for clinical practice and future research in active surveillance and focal therapy in managing localized prostate cancer. PATIENTS AND METHODS • A group of expert urologists, oncologists, radiologists, pathologists and computer scientists from North America and Europe met to discuss issues in patient population, interventions, comparators and outcome measures to use in both tissue-preserving strategies of active surveillance and focal therapy. • Break-out sessions were formed to provide agreement or highlight areas of disagreement on individual topics which were then collated by a writing group into statements that formed the basis of this report and agreed upon by the whole Transatlantic Consensus Group. RESULTS • The Transatlantic group propose that emerging diagnostic tools such as precision imaging and transperineal prostate mapping biopsy can improve prostate cancer care. These tools should be integrated into prostate cancer management and research so that better risk stratification and more effective treatment allocation can be applied. • The group envisaged a process of care in which active surveillance, focal therapy, and radical treatments lie on a continuum of complementary therapies for men with a range of disease grades and burdens, rather than being applied in the mutually exclusive and competitive way they are now. CONCLUSION • The changing landscape of prostate cancer epidemiology requires the medical community to re-evaluate the entire prostate cancer diagnostic and treatment pathway in order to minimize harms resulting from over-diagnosis and over-treatment. Precise risk stratification at every point in this pathway is required alongside paradigm shifts in our thinking about what constitutes cancer in the prostate. © 2011 BJU International. |
| Keywords: | cancer localization; cancer recurrence; cancer growth; patient selection; gadolinium; nuclear magnetic resonance imaging; sensitivity and specificity; prostate specific antigen; consensus; risk factors; cancer screening; diagnostic imaging; prostate cancer; europe; gleason score; prostatic neoplasms; prostatectomy; biopsy, needle; active surveillance; contrast enhancement; high intensity focused ultrasound; prostate biopsy; practice guidelines as topic; ablation techniques; risk stratification; nuclear magnetic resonance spectroscopy; electroporation; radiofrequency ablation; population surveillance; photodynamic therapy; predictive value; cryosurgery; north america; digital rectal examination; focal therapy; phototherapy; multi-parametric mri; template prostate mapping biopsies; trial design; kallikrein 6; transperineal prostate mapping biopsy |
| Journal Title: | BJU International |
| Volume: | 109 |
| Issue: | 11 |
| ISSN: | 1464-4096 |
| Publisher: | Wiley Blackwell |
| Date Published: | 2012-06-01 |
| Start Page: | 1636 |
| End Page: | 1647 |
| Language: | English |
| DOI: | 10.1111/j.1464-410X.2011.10633.x |
| PROVIDER: | scopus |
| PUBMED: | 22077593 |
| PMCID: | PMC3682487 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 4 June 2012" - "CODEN: BJINF" - "Source: Scopus" |
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