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1. Genetic factors associated with prostate cancer conversion from active surveillance to treatment

Author

Jiang, Y, Meyers, TJ, Emeka, AA, Cooley, LF, Cooper, PR, Lancki, N, Helenowski, I, Kachuri, L, Lin, DW, Stanford, JL, Newcomb, LF, Kolb, S, Finelli, A, Fleshner, NE, Komisarenko, M, Eastham, JA, Ehdaie, B, Benfante, N, Logothetis, CJ, Gregg, JR, Perez, CA, Garza, S, Kim, J, Marks, LS, Delfin, M, Barsa, D, Vesprini, D, Klotz, LH, Loblaw, A, Mamedov, A, Goldenberg, SL, Higano, CS, Spillane, M, Wu, E, Carter, HB, Pavlovich, CP, Mamawala, M, Landis, T, Carroll, PR, Chan, JM, Cooperberg, MR, Cowan, JE, Morgan, TM, Siddiqui, J, Martin, R, Klein, EA, Brittain, K, Gotwald, P, Barocas, DA, Dallmer, JR, Gordetsky, JB, Steele, P, Kundu, SD, Stockdale, J, Roobol, MJ, Venderbos, LDF, Sanda, MG, Arnold, R, Patil, D, Evans, CP, Dall'Era, MA, Vij, A, Costello, AJ, Chow, K, Corcoran, NM, Rais-Bahrami, S, Phares, C, Scherr, DS, Flynn, T, Karnes, RJ, Koch, M, Dhondt, CR, Nelson, JB, McBride, D, Cookson, MS, Stratton, KL, Farriester, S, Hemken, E, Stadler, WM, Pera, T, Banionyte, D, Bianco, FJ, Lopez, IH, Loeb, S, Taneja, SS, Byrne, N, Amling, CL, Martinez, A, Boileau, L, Gaylis, FD, Petkewicz, J, Kirwen, N, Helfand, BT, Xu, J, Scholtens, DM, Catalona, WJ, Witte, JS, Jiang, Y, Meyers, TJ, Emeka, AA, Cooley, LF, Cooper, PR, Lancki, N, Helenowski, I, Kachuri, L, Lin, DW, Stanford, JL, Newcomb, LF, Kolb, S, Finelli, A, Fleshner, NE, Komisarenko, M, Eastham, JA, Ehdaie, B, Benfante, N, Logothetis, CJ, Gregg, JR, Perez, CA, Garza, S, Kim, J, Marks, LS, Delfin, M, Barsa, D, Vesprini, D, Klotz, LH, Loblaw, A, Mamedov, A, Goldenberg, SL, Higano, CS, Spillane, M, Wu, E, Carter, HB, Pavlovich, CP, Mamawala, M, Landis, T, Carroll, PR, Chan, JM, Cooperberg, MR, Cowan, JE, Morgan, TM, Siddiqui, J, Martin, R, Klein, EA, Brittain, K, Gotwald, P, Barocas, DA, Dallmer, JR, Gordetsky, JB, Steele, P, Kundu, SD, Stockdale, J, Roobol, MJ, Venderbos, LDF, Sanda, MG, Arnold, R, Patil, D, Evans, CP, Dall'Era, MA, Vij, A, Costello, AJ, Chow, K, Corcoran, NM, Rais-Bahrami, S, Phares, C, Scherr, DS, Flynn, T, Karnes, RJ, Koch, M, Dhondt, CR, Nelson, JB, McBride, D, Cookson, MS, Stratton, KL, Farriester, S, Hemken, E, Stadler, WM, Pera, T, Banionyte, D, Bianco, FJ, Lopez, IH, Loeb, S, Taneja, SS, Byrne, N, Amling, CL, Martinez, A, Boileau, L, Gaylis, FD, Petkewicz, J, Kirwen, N, Helfand, BT, Xu, J, Scholtens, DM, Catalona, WJ, and Witte, JS

Abstract

Men diagnosed with low-risk prostate cancer (PC) are increasingly electing active surveillance (AS) as their initial management strategy. While this may reduce the side effects of treatment for prostate cancer, many men on AS eventually convert to active treatment. PC is one of the most heritable cancers, and genetic factors that predispose to aggressive tumors may help distinguish men who are more likely to discontinue AS. To investigate this, we undertook a multi-institutional genome-wide association study (GWAS) of 5,222 PC patients and 1,139 other patients from replication cohorts, all of whom initially elected AS and were followed over time for the potential outcome of conversion from AS to active treatment. In the GWAS we detected 18 variants associated with conversion, 15 of which were not previously associated with PC risk. With a transcriptome-wide association study (TWAS), we found two genes associated with conversion (MAST3, p = 6.9×10-7 and GAB2, p = 2.0×10-6). Moreover, increasing values of a previously validated 269-variant genetic risk score (GRS) for PC was positively associated with conversion (e.g., comparing the highest to the two middle deciles gave a hazard ratio [HR] = 1.13; 95% Confidence Interval [CI]= 0.94-1.36); whereas, decreasing values of a 36-variant GRS for prostate-specific antigen (PSA) levels were positively associated with conversion (e.g., comparing the lowest to the two middle deciles gave a HR = 1.25; 95% CI, 1.04-1.50). These results suggest that germline genetics may help inform and individualize the decision of AS-or the intensity of monitoring on AS-versus treatment for the initial management of patients with low-risk PC.

Published
2022

2. Social ecological influences on treatment decision-making in men diagnosed with low risk, localised prostate cancer

Author

McIntosh, M, Opozda, MJ, Short, CE, Galvao, DA, Tutino, R, Diefenbach, M, Ehdaie, B, Nelson, C, McIntosh, M, Opozda, MJ, Short, CE, Galvao, DA, Tutino, R, Diefenbach, M, Ehdaie, B, and Nelson, C

Abstract

OBJECTIVE: Individuals diagnosed with low risk, localised prostate cancer (PCa) face a difficult decision between active surveillance (AS) and definitive treatment. We aimed to explore perceived influences on treatment decision-making from the patient and partner's perspectives. METHODS: Patients (and partners) who met AS criteria and had chosen their treatment were recruited. Semi-structured individual interviews were conducted via telephone to explore experiences of diagnosis, impact on patient lifestyle, experiences with physicians, treatment preferences/choice, treatment information understanding and needs, and overall decision-making process. Interviews were audio recorded, transcribed verbatim, and analysed using Reflexive Thematic Analysis. RESULTS: Twenty-four male patients (18 chose AS) and 12 female partners participated. Five themes relating to social-ecological influences on treatment choice were identified: (1) partner support and direct influence on patient treatment choice, (2) patient and partner vicarious experiences may influence treatment decisions, (3) the influence of the patient's life circumstances, (4) disclosing to wider social networks: friends, family, and co-workers, and (5) the importance of a good relationship and experience with physicians. Additionally, two themes were identified relating to information patients and partners received about the treatment options during their decision-making process. CONCLUSIONS: A range of individual and social influences on treatment decision-making were reported. Physicians providing treatment recommendations should consider and discuss the patient and partner's existing beliefs and treatment preferences and encourage shared decision-making. Further research on treatment decision-making of partnered and non-partnered PCa patients is required. We recommend research considers social ecological factors across the personal, interpersonal, community, and policy levels.

Published
2022

3. Consistent Biopsy Quality and Gleason Grading Within the Global Active Surveillance Global Action Plan 3 Initiative: A Prerequisite for Future Studies.

Author

Rannikko A., Moore C.M., Gnanapragasam V., Van Hemelrijck M., Dasgupta P., Bangma C., Villers A., Valdagni R., Perry A., Hugosson J., Rubio-Briones J., Bjartell A., Hefermehl L., Shiong L.L., Frydenberg M., Kakehi Y., Chung B.H., Obbink H., van der Linden W., Hulsen T., de Jonge C., Kattan M., Xinge J., Muir K., Lophatananon A., Fahey M., Steyerberg E., Zhang L., Guo W., Benfante N., Cowan J., Patil D., Tolosa E., Kim T.-K., Mamedov A., Lapointe V., Crump T., Kimberly-Duffell J., Santaolalla A., Olivier J., Rancati T., Ahlgren H., Mascaros J., Lofgren A., Lehmann K., Lin C.H., Hirama H., Lee K.S., Jenster G., Auvinen A., Haider M., van Bochove K., Carter B., Gledhill S., Buzza M., van der Kwast T.H., Helleman J., Nieboer D., Bruinsma S.M., Roobol M.J., Trock B., Ehdaie B., Carroll P., Filson C., Kim J., Logothetis C., Morgan T., Klotz L., Pickles T., Hyndman E., Rannikko A., Moore C.M., Gnanapragasam V., Van Hemelrijck M., Dasgupta P., Bangma C., Villers A., Valdagni R., Perry A., Hugosson J., Rubio-Briones J., Bjartell A., Hefermehl L., Shiong L.L., Frydenberg M., Kakehi Y., Chung B.H., Obbink H., van der Linden W., Hulsen T., de Jonge C., Kattan M., Xinge J., Muir K., Lophatananon A., Fahey M., Steyerberg E., Zhang L., Guo W., Benfante N., Cowan J., Patil D., Tolosa E., Kim T.-K., Mamedov A., Lapointe V., Crump T., Kimberly-Duffell J., Santaolalla A., Olivier J., Rancati T., Ahlgren H., Mascaros J., Lofgren A., Lehmann K., Lin C.H., Hirama H., Lee K.S., Jenster G., Auvinen A., Haider M., van Bochove K., Carter B., Gledhill S., Buzza M., van der Kwast T.H., Helleman J., Nieboer D., Bruinsma S.M., Roobol M.J., Trock B., Ehdaie B., Carroll P., Filson C., Kim J., Logothetis C., Morgan T., Klotz L., Pickles T., and Hyndman E.

Abstract

Within the Movember Foundation's Global Action Plan Prostate Cancer Active Surveillance (GAP3) initiative, 25 centers across the globe collaborate to standardize active surveillance (AS) protocols for men with low-risk prostate cancer (PCa). A centralized PCa AS database, comprising data of more than 15 000 patients worldwide, was created. Comparability of the histopathology between the different cohorts was assessed by a centralized pathology review of 445 biopsies from 15 GAP3 centers. Grade group 1 (Gleason score 6) in 85% and grade group >=2 (Gleason score >=7) in 15% showed 89% concordance at review with moderate agreement (kappa = 0.56). Average biopsy core length was similar among the analyzed cohorts. Recently established highly adverse pathologies, including cribriform and/or intraductal carcinoma, were observed in 3.6% of the reviewed biopsies. In conclusion, the centralized pathology review of 445 biopsies revealed comparable histopathology among the 15 GAP3 centers with a low frequency of high-risk features. This enables further data analyses-without correction-toward uniform global AS guidelines for men with low-risk PCa. Patient Summary: Movember Foundation's Global Action Plan Prostate Cancer Active Surveillance (GAP3) initiative combines data from 15 000 men with low-risk prostate cancer (PCa) across the globe to standardize active surveillance protocols. Histopathology review confirmed that the histopathology was consistent with low-risk PCa in most men and comparable between different centers. A centralized pathological review showed consistent biopsy quality and Gleason grading within the global active surveillance Global Action Plan 3 initiative, a prerequisite for future studies toward uniform global guidelines for active surveillance of men with low-risk prostate cancer.Copyright © 2018

Published
2019

4. Reasons for Discontinuing Active Surveillance: Assessment of 21 Centres in 12 Countries in the Movember GAP3 Consortium.

Author

Perry A., Gledhill S., Morgan T., Klotz L., Pickles T., Hyndman E., Moore C.M., Dasgupta P., Villers A., Valdagni R., Carter B., Hugosson J., Rubio-Briones J., Bjartell A., Hefermehl L., Lui Shiong L., Kakehi Y., Ha Chung B., van der Kwast T., Obbink H., Hulsen T., de Jonge C., Xinge J., Muir K., Lophatananon A., Steyerberg E., Zhang L., Santa Olalla A., Beckmann K., Denton B., Hayen A., Boutros P., Guo W., Benfante N., Cowan J., Patil D., Tolosa E., Kim T.-K., Mamedov A., La Pointe V., Crump T., Kimberly-Duffell J., Santaolalla A., Olivier J., Rancati T., Ahlgren H., Mascaros J., Lofgren A., Lehmann K., Han Lin C., Hirama H., Suk Lee K., Jenster G., Auvinen A., Haider M., van Bochove K., Buzza M., Bangma C., Bruinsma S., Fahey M., Van Hemelrijck M., Ji X., Kattan M.W., Helleman J., Roobol M.J., Nieboer D., Bangma C.H., van der Linden W., Frydenberg M., Rannikko A., Lee L.S., Gnanapragasam V.J., Trock B., Ehdaie B., Carroll P., Filson C., Kim J., Logothetis C., Perry A., Gledhill S., Morgan T., Klotz L., Pickles T., Hyndman E., Moore C.M., Dasgupta P., Villers A., Valdagni R., Carter B., Hugosson J., Rubio-Briones J., Bjartell A., Hefermehl L., Lui Shiong L., Kakehi Y., Ha Chung B., van der Kwast T., Obbink H., Hulsen T., de Jonge C., Xinge J., Muir K., Lophatananon A., Steyerberg E., Zhang L., Santa Olalla A., Beckmann K., Denton B., Hayen A., Boutros P., Guo W., Benfante N., Cowan J., Patil D., Tolosa E., Kim T.-K., Mamedov A., La Pointe V., Crump T., Kimberly-Duffell J., Santaolalla A., Olivier J., Rancati T., Ahlgren H., Mascaros J., Lofgren A., Lehmann K., Han Lin C., Hirama H., Suk Lee K., Jenster G., Auvinen A., Haider M., van Bochove K., Buzza M., Bangma C., Bruinsma S., Fahey M., Van Hemelrijck M., Ji X., Kattan M.W., Helleman J., Roobol M.J., Nieboer D., Bangma C.H., van der Linden W., Frydenberg M., Rannikko A., Lee L.S., Gnanapragasam V.J., Trock B., Ehdaie B., Carroll P., Filson C., Kim J., and Logothetis C.

Abstract

Background: Careful assessment of the reasons for discontinuation of active surveillance (AS) is required for men with prostate cancer (PCa). Objective(s): Using Movember's Global Action Plan Prostate Cancer Active Surveillance initiative (GAP3) database, we report on reasons for AS discontinuation. Design, setting, and participants: We compared data from 10 296 men on AS from 21 centres across 12 countries. Outcome measurements and statistical analysis: Cumulative incidence methods were used to estimate the cumulative incidence rates of AS discontinuation. Results and limitations: During 5-yr follow-up, 27.5% (95% confidence interval [CI]: 26.4-28.6%) men showed signs of disease progression, 12.8% (95% CI: 12.0-13.6%) converted to active treatment without evidence of progression, 1.7% (95% CI: 1.5-2.0%) continued to watchful waiting, and 1.7% (95% CI: 1.4-2.1%) died from other causes. Of the 7049 men who remained on AS, 2339 had follow-up for >5 yr, 4561 had follow-up for <5 yr, and 149 were lost to follow-up. Cumulative incidence of progression was 27.5% (95% CI: 26.4-28.6%) at 5 yr and 38.2% (95% CI: 36.7-39.9%) at 10 yr. A limitation is that not all centres were included due to limited information on the reason for discontinuation and limited follow-up. Conclusion(s): Our descriptive analyses of current AS practices worldwide showed that 43.6% of men drop out of AS during 5-yr follow-up, mainly due to signs of disease progression. Improvements in selection tools for AS are thus needed to correctly allocate men with PCa to AS, which will also reduce discontinuation due to conversion to active treatment without evidence of disease progression. Patient Summary: Our assessment of a worldwide database of men with prostate cancer (PCa) on active surveillance (AS) shows that 43.6% drop out of AS within 5 yr, mainly due to signs of disease progression. Better tools are needed to select and monitor men with PCa as part of AS. After about 5 yr, about 56% of men were still

Published
2019

5. Predicting Biopsy Outcomes During Active Surveillance for Prostate Cancer: External Validation of the Canary Prostate Active Surveillance Study Risk Calculators in Five Large Active Surveillance Cohorts.

Author

Santaolalla A., Gnanapragasam V., Van Hemelrijck M., Dasgupta P., Auvinen A., Haider M., van Bochove K., Carter B., Gledhill S., Buzza M., Bruinsma S., Helleman J., Drost F.-J.H., Nieboer D., Morgan T.M., Carroll P.R., Roobol M.J., Trock B., Ehdaie B., Carroll P., Filson C., Kim J., Logothetis C., Morgan T., Klotz L., Pickles T., Hyndman E., Bangma C., Roobol M., Villers A., Rannikko A., Valdagni R., Perry A., Hugosson J., Rubio-Briones J., Bjartell A., Hefermehl L., Shiong L.L., Frydenberg M., Kakehi Y., Chung B.H., van der Kwast T., van der Linden W., Hulsen T., de Jonge C., Kattan M., Xinge J., Muir K., Lophatananon A., Fahey M., Steyerberg E., Zhang L., Beckmann K., Denton B., Hayen A., Boutros P., Guo W., Benfante N., Cowan J., Patil D., Tolosa E., Kim T.-K., Mamedov A., Lapointe V., Crump T., Kimberly-Duffell J., Olivier J., Rancati T., Ahlgren H., Mascaros J., Lofgren A., Lin C.H., Hirama H., Lee K.S., Moore C.M., Jenster G., Santaolalla A., Gnanapragasam V., Van Hemelrijck M., Dasgupta P., Auvinen A., Haider M., van Bochove K., Carter B., Gledhill S., Buzza M., Bruinsma S., Helleman J., Drost F.-J.H., Nieboer D., Morgan T.M., Carroll P.R., Roobol M.J., Trock B., Ehdaie B., Carroll P., Filson C., Kim J., Logothetis C., Morgan T., Klotz L., Pickles T., Hyndman E., Bangma C., Roobol M., Villers A., Rannikko A., Valdagni R., Perry A., Hugosson J., Rubio-Briones J., Bjartell A., Hefermehl L., Shiong L.L., Frydenberg M., Kakehi Y., Chung B.H., van der Kwast T., van der Linden W., Hulsen T., de Jonge C., Kattan M., Xinge J., Muir K., Lophatananon A., Fahey M., Steyerberg E., Zhang L., Beckmann K., Denton B., Hayen A., Boutros P., Guo W., Benfante N., Cowan J., Patil D., Tolosa E., Kim T.-K., Mamedov A., Lapointe V., Crump T., Kimberly-Duffell J., Olivier J., Rancati T., Ahlgren H., Mascaros J., Lofgren A., Lin C.H., Hirama H., Lee K.S., Moore C.M., and Jenster G.

Abstract

Two active surveillance risk calculators to predict disease reclassification on prostate biopsy are externally validated by the Movember Foundation's Global Action Plan (GAP3) consortium. They proved to be clinically useful and could reduce unnecessary biopsies, but need recalibration to local settings. Background: Men with prostate cancer (PCa) on active surveillance (AS) are followed through regular prostate biopsies, a burdensome and often unnecessary intervention, not without risks. Identifying men with at a low risk of disease reclassification may help reduce the number of biopsies. Objective(s): To assess the external validity of two Canary Prostate Active Surveillance Study Risk Calculators (PASS-RCs), which estimate the probability of reclassification (Gleason grade >=7 with or without >34% of biopsy cores positive for PCa) on a surveillance biopsy, using a mix of months since last biopsy, age, body mass index, prostate-specific antigen, prostate volume, number of prior negative biopsies, and percentage (or ratio) of positive cores on last biopsy. Design, setting, and participants: We used data up to November 2017 from the Movember Foundation's Global Action Plan (GAP3) consortium, a global collaboration between AS studies. Outcome measurements and statistical analysis: External validity of the PASS-RCs for estimating reclassification on biopsy was assessed by calibration, discrimination, and decision curve analyses. Results and limitations: Five validation cohorts (Prostate Cancer Research International: Active Surveillance, Johns Hopkins, Toronto, Memorial Sloan Kettering Cancer Center, and University of California San Francisco), comprising 5105 men on AS, were eligible for analysis. The individual cohorts comprised 429-2416 men, with a median follow-up between 36 and 84 mo, in both community and academic practices mainly from western countries. Abilities of the PASS-RCs to discriminate between men with and without reclassification on biopsy were reasonab

Published
2019

6. Consistent Biopsy Quality and Gleason Grading Within the Global Active Surveillance Global Action Plan 3 Initiative: A Prerequisite for Future Studies.

Author

Rannikko A., Moore C.M., Gnanapragasam V., Van Hemelrijck M., Dasgupta P., Bangma C., Villers A., Valdagni R., Perry A., Hugosson J., Rubio-Briones J., Bjartell A., Hefermehl L., Shiong L.L., Frydenberg M., Kakehi Y., Chung B.H., Obbink H., van der Linden W., Hulsen T., de Jonge C., Kattan M., Xinge J., Muir K., Lophatananon A., Fahey M., Steyerberg E., Zhang L., Guo W., Benfante N., Cowan J., Patil D., Tolosa E., Kim T.-K., Mamedov A., Lapointe V., Crump T., Kimberly-Duffell J., Santaolalla A., Olivier J., Rancati T., Ahlgren H., Mascaros J., Lofgren A., Lehmann K., Lin C.H., Hirama H., Lee K.S., Jenster G., Auvinen A., Haider M., van Bochove K., Carter B., Gledhill S., Buzza M., van der Kwast T.H., Helleman J., Nieboer D., Bruinsma S.M., Roobol M.J., Trock B., Ehdaie B., Carroll P., Filson C., Kim J., Logothetis C., Morgan T., Klotz L., Pickles T., Hyndman E., Rannikko A., Moore C.M., Gnanapragasam V., Van Hemelrijck M., Dasgupta P., Bangma C., Villers A., Valdagni R., Perry A., Hugosson J., Rubio-Briones J., Bjartell A., Hefermehl L., Shiong L.L., Frydenberg M., Kakehi Y., Chung B.H., Obbink H., van der Linden W., Hulsen T., de Jonge C., Kattan M., Xinge J., Muir K., Lophatananon A., Fahey M., Steyerberg E., Zhang L., Guo W., Benfante N., Cowan J., Patil D., Tolosa E., Kim T.-K., Mamedov A., Lapointe V., Crump T., Kimberly-Duffell J., Santaolalla A., Olivier J., Rancati T., Ahlgren H., Mascaros J., Lofgren A., Lehmann K., Lin C.H., Hirama H., Lee K.S., Jenster G., Auvinen A., Haider M., van Bochove K., Carter B., Gledhill S., Buzza M., van der Kwast T.H., Helleman J., Nieboer D., Bruinsma S.M., Roobol M.J., Trock B., Ehdaie B., Carroll P., Filson C., Kim J., Logothetis C., Morgan T., Klotz L., Pickles T., and Hyndman E.

Abstract

Within the Movember Foundation's Global Action Plan Prostate Cancer Active Surveillance (GAP3) initiative, 25 centers across the globe collaborate to standardize active surveillance (AS) protocols for men with low-risk prostate cancer (PCa). A centralized PCa AS database, comprising data of more than 15 000 patients worldwide, was created. Comparability of the histopathology between the different cohorts was assessed by a centralized pathology review of 445 biopsies from 15 GAP3 centers. Grade group 1 (Gleason score 6) in 85% and grade group >=2 (Gleason score >=7) in 15% showed 89% concordance at review with moderate agreement (kappa = 0.56). Average biopsy core length was similar among the analyzed cohorts. Recently established highly adverse pathologies, including cribriform and/or intraductal carcinoma, were observed in 3.6% of the reviewed biopsies. In conclusion, the centralized pathology review of 445 biopsies revealed comparable histopathology among the 15 GAP3 centers with a low frequency of high-risk features. This enables further data analyses-without correction-toward uniform global AS guidelines for men with low-risk PCa. Patient Summary: Movember Foundation's Global Action Plan Prostate Cancer Active Surveillance (GAP3) initiative combines data from 15 000 men with low-risk prostate cancer (PCa) across the globe to standardize active surveillance protocols. Histopathology review confirmed that the histopathology was consistent with low-risk PCa in most men and comparable between different centers. A centralized pathological review showed consistent biopsy quality and Gleason grading within the global active surveillance Global Action Plan 3 initiative, a prerequisite for future studies toward uniform global guidelines for active surveillance of men with low-risk prostate cancer.Copyright © 2018

Published
2019

7. Reasons for Discontinuing Active Surveillance: Assessment of 21 Centres in 12 Countries in the Movember GAP3 Consortium.

Author

Perry A., Gledhill S., Morgan T., Klotz L., Pickles T., Hyndman E., Moore C.M., Dasgupta P., Villers A., Valdagni R., Carter B., Hugosson J., Rubio-Briones J., Bjartell A., Hefermehl L., Lui Shiong L., Kakehi Y., Ha Chung B., van der Kwast T., Obbink H., Hulsen T., de Jonge C., Xinge J., Muir K., Lophatananon A., Steyerberg E., Zhang L., Santa Olalla A., Beckmann K., Denton B., Hayen A., Boutros P., Guo W., Benfante N., Cowan J., Patil D., Tolosa E., Kim T.-K., Mamedov A., La Pointe V., Crump T., Kimberly-Duffell J., Santaolalla A., Olivier J., Rancati T., Ahlgren H., Mascaros J., Lofgren A., Lehmann K., Han Lin C., Hirama H., Suk Lee K., Jenster G., Auvinen A., Haider M., van Bochove K., Buzza M., Bangma C., Bruinsma S., Fahey M., Van Hemelrijck M., Ji X., Kattan M.W., Helleman J., Roobol M.J., Nieboer D., Bangma C.H., van der Linden W., Frydenberg M., Rannikko A., Lee L.S., Gnanapragasam V.J., Trock B., Ehdaie B., Carroll P., Filson C., Kim J., Logothetis C., Perry A., Gledhill S., Morgan T., Klotz L., Pickles T., Hyndman E., Moore C.M., Dasgupta P., Villers A., Valdagni R., Carter B., Hugosson J., Rubio-Briones J., Bjartell A., Hefermehl L., Lui Shiong L., Kakehi Y., Ha Chung B., van der Kwast T., Obbink H., Hulsen T., de Jonge C., Xinge J., Muir K., Lophatananon A., Steyerberg E., Zhang L., Santa Olalla A., Beckmann K., Denton B., Hayen A., Boutros P., Guo W., Benfante N., Cowan J., Patil D., Tolosa E., Kim T.-K., Mamedov A., La Pointe V., Crump T., Kimberly-Duffell J., Santaolalla A., Olivier J., Rancati T., Ahlgren H., Mascaros J., Lofgren A., Lehmann K., Han Lin C., Hirama H., Suk Lee K., Jenster G., Auvinen A., Haider M., van Bochove K., Buzza M., Bangma C., Bruinsma S., Fahey M., Van Hemelrijck M., Ji X., Kattan M.W., Helleman J., Roobol M.J., Nieboer D., Bangma C.H., van der Linden W., Frydenberg M., Rannikko A., Lee L.S., Gnanapragasam V.J., Trock B., Ehdaie B., Carroll P., Filson C., Kim J., and Logothetis C.

Abstract

Background: Careful assessment of the reasons for discontinuation of active surveillance (AS) is required for men with prostate cancer (PCa). Objective(s): Using Movember's Global Action Plan Prostate Cancer Active Surveillance initiative (GAP3) database, we report on reasons for AS discontinuation. Design, setting, and participants: We compared data from 10 296 men on AS from 21 centres across 12 countries. Outcome measurements and statistical analysis: Cumulative incidence methods were used to estimate the cumulative incidence rates of AS discontinuation. Results and limitations: During 5-yr follow-up, 27.5% (95% confidence interval [CI]: 26.4-28.6%) men showed signs of disease progression, 12.8% (95% CI: 12.0-13.6%) converted to active treatment without evidence of progression, 1.7% (95% CI: 1.5-2.0%) continued to watchful waiting, and 1.7% (95% CI: 1.4-2.1%) died from other causes. Of the 7049 men who remained on AS, 2339 had follow-up for >5 yr, 4561 had follow-up for <5 yr, and 149 were lost to follow-up. Cumulative incidence of progression was 27.5% (95% CI: 26.4-28.6%) at 5 yr and 38.2% (95% CI: 36.7-39.9%) at 10 yr. A limitation is that not all centres were included due to limited information on the reason for discontinuation and limited follow-up. Conclusion(s): Our descriptive analyses of current AS practices worldwide showed that 43.6% of men drop out of AS during 5-yr follow-up, mainly due to signs of disease progression. Improvements in selection tools for AS are thus needed to correctly allocate men with PCa to AS, which will also reduce discontinuation due to conversion to active treatment without evidence of disease progression. Patient Summary: Our assessment of a worldwide database of men with prostate cancer (PCa) on active surveillance (AS) shows that 43.6% drop out of AS within 5 yr, mainly due to signs of disease progression. Better tools are needed to select and monitor men with PCa as part of AS. After about 5 yr, about 56% of men were still

Published
2019

8. Predicting Biopsy Outcomes During Active Surveillance for Prostate Cancer: External Validation of the Canary Prostate Active Surveillance Study Risk Calculators in Five Large Active Surveillance Cohorts.

Author

Santaolalla A., Gnanapragasam V., Van Hemelrijck M., Dasgupta P., Auvinen A., Haider M., van Bochove K., Carter B., Gledhill S., Buzza M., Bruinsma S., Helleman J., Drost F.-J.H., Nieboer D., Morgan T.M., Carroll P.R., Roobol M.J., Trock B., Ehdaie B., Carroll P., Filson C., Kim J., Logothetis C., Morgan T., Klotz L., Pickles T., Hyndman E., Bangma C., Roobol M., Villers A., Rannikko A., Valdagni R., Perry A., Hugosson J., Rubio-Briones J., Bjartell A., Hefermehl L., Shiong L.L., Frydenberg M., Kakehi Y., Chung B.H., van der Kwast T., van der Linden W., Hulsen T., de Jonge C., Kattan M., Xinge J., Muir K., Lophatananon A., Fahey M., Steyerberg E., Zhang L., Beckmann K., Denton B., Hayen A., Boutros P., Guo W., Benfante N., Cowan J., Patil D., Tolosa E., Kim T.-K., Mamedov A., Lapointe V., Crump T., Kimberly-Duffell J., Olivier J., Rancati T., Ahlgren H., Mascaros J., Lofgren A., Lin C.H., Hirama H., Lee K.S., Moore C.M., Jenster G., Santaolalla A., Gnanapragasam V., Van Hemelrijck M., Dasgupta P., Auvinen A., Haider M., van Bochove K., Carter B., Gledhill S., Buzza M., Bruinsma S., Helleman J., Drost F.-J.H., Nieboer D., Morgan T.M., Carroll P.R., Roobol M.J., Trock B., Ehdaie B., Carroll P., Filson C., Kim J., Logothetis C., Morgan T., Klotz L., Pickles T., Hyndman E., Bangma C., Roobol M., Villers A., Rannikko A., Valdagni R., Perry A., Hugosson J., Rubio-Briones J., Bjartell A., Hefermehl L., Shiong L.L., Frydenberg M., Kakehi Y., Chung B.H., van der Kwast T., van der Linden W., Hulsen T., de Jonge C., Kattan M., Xinge J., Muir K., Lophatananon A., Fahey M., Steyerberg E., Zhang L., Beckmann K., Denton B., Hayen A., Boutros P., Guo W., Benfante N., Cowan J., Patil D., Tolosa E., Kim T.-K., Mamedov A., Lapointe V., Crump T., Kimberly-Duffell J., Olivier J., Rancati T., Ahlgren H., Mascaros J., Lofgren A., Lin C.H., Hirama H., Lee K.S., Moore C.M., and Jenster G.

Abstract

Two active surveillance risk calculators to predict disease reclassification on prostate biopsy are externally validated by the Movember Foundation's Global Action Plan (GAP3) consortium. They proved to be clinically useful and could reduce unnecessary biopsies, but need recalibration to local settings. Background: Men with prostate cancer (PCa) on active surveillance (AS) are followed through regular prostate biopsies, a burdensome and often unnecessary intervention, not without risks. Identifying men with at a low risk of disease reclassification may help reduce the number of biopsies. Objective(s): To assess the external validity of two Canary Prostate Active Surveillance Study Risk Calculators (PASS-RCs), which estimate the probability of reclassification (Gleason grade >=7 with or without >34% of biopsy cores positive for PCa) on a surveillance biopsy, using a mix of months since last biopsy, age, body mass index, prostate-specific antigen, prostate volume, number of prior negative biopsies, and percentage (or ratio) of positive cores on last biopsy. Design, setting, and participants: We used data up to November 2017 from the Movember Foundation's Global Action Plan (GAP3) consortium, a global collaboration between AS studies. Outcome measurements and statistical analysis: External validity of the PASS-RCs for estimating reclassification on biopsy was assessed by calibration, discrimination, and decision curve analyses. Results and limitations: Five validation cohorts (Prostate Cancer Research International: Active Surveillance, Johns Hopkins, Toronto, Memorial Sloan Kettering Cancer Center, and University of California San Francisco), comprising 5105 men on AS, were eligible for analysis. The individual cohorts comprised 429-2416 men, with a median follow-up between 36 and 84 mo, in both community and academic practices mainly from western countries. Abilities of the PASS-RCs to discriminate between men with and without reclassification on biopsy were reasonab

Published
2019

9. Predicting Biopsy Outcomes During Active Surveillance for Prostate Cancer: External Validation of the Canary Prostate Active Surveillance Study Risk Calculators in Five Large Active Surveillance Cohorts

Author

Drost, FJH, Nieboer, D, Morgan, TM, Carroll, PR, Roobol, MJ, Trock, B, Ehdaie, B, Carroll, P, Filson, C, Kim, J, Logothetis, C, Morgan, T, Klotz, L, Pickles, T, Hyndman, E, Moore, CM, Gnanapragasam, V, Van Hemelrijck, M, Dasgupta, P, Bangma, C, Roobol, M, Villers, A, Rannikko, A, Valdagni, R, Perry, A, Hugosson, J, Rubio-Briones, J, Bjartell, A, Hefermehl, L, Shiong, LL, Frydenberg, M, Kakehi, Y, Chung, BH, van der Kwast, T, van der Linden, W, Hulsen, T, de Jonge, C, Kattan, M, Xinge, J, Muir, K, Lophatananon, A, Fahey, M, Steyerberg, E, Zhang, L, Beckmann, K, Denton, B, Hayen, A, Boutros, P, Guo, W, Benfante, N, Cowan, J, Patil, D, Tolosa, E, Kim, TK, Mamedov, A, Lapointe, V, Crump, T, Kimberly-Duffell, J, Santaolalla, A, Olivier, J, Rancati, T, Ahlgren, H, Mascarós, J, Löfgren, A, Lin, CH, Hirama, H, Lee, KS, Jenster, G, Auvinen, A, Haider, M, van Bochove, K, Carter, B, Gledhill, S, Buzza, M, Bruinsma, S, Helleman, J, Drost, FJH, Nieboer, D, Morgan, TM, Carroll, PR, Roobol, MJ, Trock, B, Ehdaie, B, Carroll, P, Filson, C, Kim, J, Logothetis, C, Morgan, T, Klotz, L, Pickles, T, Hyndman, E, Moore, CM, Gnanapragasam, V, Van Hemelrijck, M, Dasgupta, P, Bangma, C, Roobol, M, Villers, A, Rannikko, A, Valdagni, R, Perry, A, Hugosson, J, Rubio-Briones, J, Bjartell, A, Hefermehl, L, Shiong, LL, Frydenberg, M, Kakehi, Y, Chung, BH, van der Kwast, T, van der Linden, W, Hulsen, T, de Jonge, C, Kattan, M, Xinge, J, Muir, K, Lophatananon, A, Fahey, M, Steyerberg, E, Zhang, L, Beckmann, K, Denton, B, Hayen, A, Boutros, P, Guo, W, Benfante, N, Cowan, J, Patil, D, Tolosa, E, Kim, TK, Mamedov, A, Lapointe, V, Crump, T, Kimberly-Duffell, J, Santaolalla, A, Olivier, J, Rancati, T, Ahlgren, H, Mascarós, J, Löfgren, A, Lin, CH, Hirama, H, Lee, KS, Jenster, G, Auvinen, A, Haider, M, van Bochove, K, Carter, B, Gledhill, S, Buzza, M, Bruinsma, S, and Helleman, J

Abstract

© 2019 European Association of Urology Two active surveillance risk calculators to predict disease reclassification on prostate biopsy are externally validated by the Movember Foundation's Global Action Plan (GAP3) consortium. They proved to be clinically useful and could reduce unnecessary biopsies, but need recalibration to local settings.

Published
2019

10. The Movember Foundation's GAP3 cohort

Author

Bruinsma, S.M. (Sophie), Zhang, L. (Liying), Roobol-Bouts, M.J. (Monique), Bangma, C.H. (Chris), Steyerberg, E.W. (Ewout), Nieboer, D. (Daan), Van Hemelrijck, M. (Mieke), Trock, B.J. (Bruce), Ehdaie, B. (Behfar), Carroll, P.R. (Peter), Filson, C. (Christopher), Kim, J. (Jeri), Morgan, T. (Todd), Klotz, L. (Laurence), Pickles, T. (Tom), Hyndman, E. (Eric), Moore, C.M. (Caroline), Gnanapragasam, V. (Vincent), Dasgupta, P. (Prokar), Villers, A. (Arnoud), Rannikko, A.S. (Antti), Valdagni, R. (Riccardo), Perry, A. (Antoinette), Hugosson, J. (Jonas), Rubio-Briones, J. (Jose), Bjartell, A. (Anders), Hefermehl, L. (Lukas), Lui Shiong, L. (Lee), Frydenberg, M. (Mark), Kakehi, Y. (Yoshiyuki), Ha Chung, B. (Byung), Kwast, Th.H. (Theo) van der, Obbink, H. (Henk), van der Linden, W. (Wim), Hulsen, T. (Tim), de Jonge, C. (Cees), Kattan, M.W. (Michael), Xinge, J. (Ji), Muir, K. (Kenneth), Lophatananon, A. (Artitaya), Fahey, M. (Michael), Guo, W. (Wei), Milan, T. (Tanya), Benfante, N. (Nicole), Cowan, J. (Janet), Patil, D. (Dattatraya), Sanford, R. (Rachel), Kim, T.-K. (Tae-Kyung), Mamedov, A. (Alexandre), LaPointe, V. (Vincent), Crump, T. (Trafford), Hamoudi, R. (Rifat), Kimberly-Duffell, J. (Jenna), Santaolalla, A. (Aida), Olivier, J. (Jonathan), Janetti, E.B. (Emanuele Bianchi), Rancati, T. (Tiziana), Ahlgren, H. (Helén), Mascarós, J. (Juanma), Löfgren, A. (Annica), Lehmann, K. (Kurt), Han Lin, C. (Catherine), Hirama, H. (Hiromi), Jenster, G.W. (Guido), Auvinen, A. (Anssi), Haider, M. (Masoom), van Bochove, K. (Kees), Carter, B. (Ballentine), Kirk-Burnnand, R. (Rachelle), Gledhill, S. (Sam), Buzza, M. (Mark), Bruinsma, S.M. (Sophie), Zhang, L. (Liying), Roobol-Bouts, M.J. (Monique), Bangma, C.H. (Chris), Steyerberg, E.W. (Ewout), Nieboer, D. (Daan), Van Hemelrijck, M. (Mieke), Trock, B.J. (Bruce), Ehdaie, B. (Behfar), Carroll, P.R. (Peter), Filson, C. (Christopher), Kim, J. (Jeri), Morgan, T. (Todd), Klotz, L. (Laurence), Pickles, T. (Tom), Hyndman, E. (Eric), Moore, C.M. (Caroline), Gnanapragasam, V. (Vincent), Dasgupta, P. (Prokar), Villers, A. (Arnoud), Rannikko, A.S. (Antti), Valdagni, R. (Riccardo), Perry, A. (Antoinette), Hugosson, J. (Jonas), Rubio-Briones, J. (Jose), Bjartell, A. (Anders), Hefermehl, L. (Lukas), Lui Shiong, L. (Lee), Frydenberg, M. (Mark), Kakehi, Y. (Yoshiyuki), Ha Chung, B. (Byung), Kwast, Th.H. (Theo) van der, Obbink, H. (Henk), van der Linden, W. (Wim), Hulsen, T. (Tim), de Jonge, C. (Cees), Kattan, M.W. (Michael), Xinge, J. (Ji), Muir, K. (Kenneth), Lophatananon, A. (Artitaya), Fahey, M. (Michael), Guo, W. (Wei), Milan, T. (Tanya), Benfante, N. (Nicole), Cowan, J. (Janet), Patil, D. (Dattatraya), Sanford, R. (Rachel), Kim, T.-K. (Tae-Kyung), Mamedov, A. (Alexandre), LaPointe, V. (Vincent), Crump, T. (Trafford), Hamoudi, R. (Rifat), Kimberly-Duffell, J. (Jenna), Santaolalla, A. (Aida), Olivier, J. (Jonathan), Janetti, E.B. (Emanuele Bianchi), Rancati, T. (Tiziana), Ahlgren, H. (Helén), Mascarós, J. (Juanma), Löfgren, A. (Annica), Lehmann, K. (Kurt), Han Lin, C. (Catherine), Hirama, H. (Hiromi), Jenster, G.W. (Guido), Auvinen, A. (Anssi), Haider, M. (Masoom), van Bochove, K. (Kees), Carter, B. (Ballentine), Kirk-Burnnand, R. (Rachelle), Gledhill, S. (Sam), and Buzza, M. (Mark)

Abstract

Objectives: The Movember Foundation launched the Global Action Plan Prostate Cancer Active Surveillance (GAP3) initiative to create a global consensus on the selection and monitoring of men with low-risk prostate cancer (PCa) on active surveillance (AS). The aim of this study is to present data on inclusion and follow-up for AS in this unique global AS database. Patients and Methods: Between 2014 and 2016, the database was created by combining patient data from 25 established AS cohorts worldwide (USA, Canada, Australasia, UK and Europe). Data on a total of 15 101 patients were included. Descriptive statistics were used to report patients' clinical and demographic characteristics at the time of PCa diagnosis, clinical follow-up, discontinuation of AS and subsequent treatment. Cumulative incidence curves were used to report discontinuation rates over time. Results: At diagnosis, the median (interquartile range [IQR]) patient age was 65 (60–70) years and the median prostate-specific antigen level was 5.4 (4.0–7.3) ng/mL. Most patients had clinical stage T1 disease (71.8%), a biopsy Gleason score of 6 (88.8%) and one tumour-positive biopsy core (60.3%). Patients on AS had a median follow-up time of 2.2 (1.0–5.0) years. After 5, 10 and 15 years of follow-up, respectively, 58%, 39% and 23% of patients were still on AS. The current version of GAP3 has limited data on magnetic resonance imaging (MRI), quality of life and genomic testing. Conclusions: GAP3 is the largest worldwide collaboration integrating patient data from men with PCa on AS. The results will allow individual patients and clinicians to have greater confidence in the personalized decision to either delay or proceed with active treatment. Longer follow-up and the evaluation of MRI, new genomic markers and patient-related outcomes will result in even more valuable data and eventually in better patient outcomes.

Published
2018
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11. Expert consensus document: Semantics in active surveillance for men with localized prostate cancer-results of a modified Delphi consensus procedure.

Author

van der Linden W., Bruinsma S.M., Roobol M.J., Carroll P.R., Klotz L., Pickles T., Moore C.M., Gnanapragasam V.J., Villers A., Rannikko A., Valdagni R., Frydenberg M., Kakehi Y., Filson C.P., Bangma C.H., Trock B., Ehdaie B., Kim J., Morgan T., Hyndman E., Van Hemelrijck M., Dasgupta P., Perry A., Hugosson J., Rubio-Briones J., Bjartell A., Hefermehl L., Lui Shiong L., Ha Chung B., Suk Lee K., van der Kwast T., Obbink H., Hulsen T., de Jonge C., Kattan M., Xinge J., Muir K., Lophatananon A., Fahey M., Steyerberg E., Nieboer D., Zhang L., Guo W., Milan T., Benfante N., Cowan J., Patil D., Sanford R., Kim T.K., Mamedov A., LaPointe V., Crump T., Hamoudi R., Kimberly-Duffell J., Santaolalla A., Olivier J., Janetti E.B., Rancati T., Ahlgren H., Mascaros J., Lofgren A., Lehmann K., Han Lin C., Hirama H., Jenster G., Auvinen A., Haider M., van Bochove K., Carter B., Kirk-Burnnand R., Gledhill S., Buzza M., van der Linden W., Bruinsma S.M., Roobol M.J., Carroll P.R., Klotz L., Pickles T., Moore C.M., Gnanapragasam V.J., Villers A., Rannikko A., Valdagni R., Frydenberg M., Kakehi Y., Filson C.P., Bangma C.H., Trock B., Ehdaie B., Kim J., Morgan T., Hyndman E., Van Hemelrijck M., Dasgupta P., Perry A., Hugosson J., Rubio-Briones J., Bjartell A., Hefermehl L., Lui Shiong L., Ha Chung B., Suk Lee K., van der Kwast T., Obbink H., Hulsen T., de Jonge C., Kattan M., Xinge J., Muir K., Lophatananon A., Fahey M., Steyerberg E., Nieboer D., Zhang L., Guo W., Milan T., Benfante N., Cowan J., Patil D., Sanford R., Kim T.K., Mamedov A., LaPointe V., Crump T., Hamoudi R., Kimberly-Duffell J., Santaolalla A., Olivier J., Janetti E.B., Rancati T., Ahlgren H., Mascaros J., Lofgren A., Lehmann K., Han Lin C., Hirama H., Jenster G., Auvinen A., Haider M., van Bochove K., Carter B., Kirk-Burnnand R., Gledhill S., and Buzza M.

Abstract

Active surveillance (AS) is broadly described as a management option for men with low-risk prostate cancer, but semantic heterogeneity exists in both the literature and in guidelines. To address this issue, a panel of leading prostate cancer specialists in the field of AS participated in a consensus-forming project using a modified Delphi method to reach international consensus on definitions of terms related to this management option. An iterative three-round sequence of online questionnaires designed to address 61 individual items was completed by each panel member. Consensus was considered to be reached if >=70% of the experts agreed on a definition. To facilitate a common understanding among all experts involved and resolve potential ambiguities, a face-to-face consensus meeting was held between Delphi survey rounds two and three. Convenience sampling was used to construct the panel of experts. In total, 12 experts from Australia, France, Finland, Italy, the Netherlands, Japan, the UK, Canada and the USA participated. By the end of the Delphi process, formal consensus was achieved for 100% (n = 61) of the terms and a glossary was then developed. Agreement between international experts has been reached on relevant terms and subsequent definitions regarding AS for patients with localized prostate cancer. This standard terminology could support multidisciplinary communication, reduce the extent of variations in clinical practice and optimize clinical decision making.Copyright © 2017 Macmillan Publishers Limited, part of Springer Nature. All rights reserved.

Published
2017

12. Expert consensus document: Semantics in active surveillance for men with localized prostate cancer-results of a modified Delphi consensus procedure.

Author

van der Linden W., Bruinsma S.M., Roobol M.J., Carroll P.R., Klotz L., Pickles T., Moore C.M., Gnanapragasam V.J., Villers A., Rannikko A., Valdagni R., Frydenberg M., Kakehi Y., Filson C.P., Bangma C.H., Trock B., Ehdaie B., Kim J., Morgan T., Hyndman E., Van Hemelrijck M., Dasgupta P., Perry A., Hugosson J., Rubio-Briones J., Bjartell A., Hefermehl L., Lui Shiong L., Ha Chung B., Suk Lee K., van der Kwast T., Obbink H., Hulsen T., de Jonge C., Kattan M., Xinge J., Muir K., Lophatananon A., Fahey M., Steyerberg E., Nieboer D., Zhang L., Guo W., Milan T., Benfante N., Cowan J., Patil D., Sanford R., Kim T.K., Mamedov A., LaPointe V., Crump T., Hamoudi R., Kimberly-Duffell J., Santaolalla A., Olivier J., Janetti E.B., Rancati T., Ahlgren H., Mascaros J., Lofgren A., Lehmann K., Han Lin C., Hirama H., Jenster G., Auvinen A., Haider M., van Bochove K., Carter B., Kirk-Burnnand R., Gledhill S., Buzza M., van der Linden W., Bruinsma S.M., Roobol M.J., Carroll P.R., Klotz L., Pickles T., Moore C.M., Gnanapragasam V.J., Villers A., Rannikko A., Valdagni R., Frydenberg M., Kakehi Y., Filson C.P., Bangma C.H., Trock B., Ehdaie B., Kim J., Morgan T., Hyndman E., Van Hemelrijck M., Dasgupta P., Perry A., Hugosson J., Rubio-Briones J., Bjartell A., Hefermehl L., Lui Shiong L., Ha Chung B., Suk Lee K., van der Kwast T., Obbink H., Hulsen T., de Jonge C., Kattan M., Xinge J., Muir K., Lophatananon A., Fahey M., Steyerberg E., Nieboer D., Zhang L., Guo W., Milan T., Benfante N., Cowan J., Patil D., Sanford R., Kim T.K., Mamedov A., LaPointe V., Crump T., Hamoudi R., Kimberly-Duffell J., Santaolalla A., Olivier J., Janetti E.B., Rancati T., Ahlgren H., Mascaros J., Lofgren A., Lehmann K., Han Lin C., Hirama H., Jenster G., Auvinen A., Haider M., van Bochove K., Carter B., Kirk-Burnnand R., Gledhill S., and Buzza M.

Abstract

Active surveillance (AS) is broadly described as a management option for men with low-risk prostate cancer, but semantic heterogeneity exists in both the literature and in guidelines. To address this issue, a panel of leading prostate cancer specialists in the field of AS participated in a consensus-forming project using a modified Delphi method to reach international consensus on definitions of terms related to this management option. An iterative three-round sequence of online questionnaires designed to address 61 individual items was completed by each panel member. Consensus was considered to be reached if >=70% of the experts agreed on a definition. To facilitate a common understanding among all experts involved and resolve potential ambiguities, a face-to-face consensus meeting was held between Delphi survey rounds two and three. Convenience sampling was used to construct the panel of experts. In total, 12 experts from Australia, France, Finland, Italy, the Netherlands, Japan, the UK, Canada and the USA participated. By the end of the Delphi process, formal consensus was achieved for 100% (n = 61) of the terms and a glossary was then developed. Agreement between international experts has been reached on relevant terms and subsequent definitions regarding AS for patients with localized prostate cancer. This standard terminology could support multidisciplinary communication, reduce the extent of variations in clinical practice and optimize clinical decision making.Copyright © 2017 Macmillan Publishers Limited, part of Springer Nature. All rights reserved.

Published
2017

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