63 results on '"Cornford P"'
Search Results
2. Development of a predictive model for death amongst patients with Metastatic Hormone Sensitive Prostate Cancer (mHSPC) treated with one of the approved treatment plans, on characteristics present at admission using Big data: Preliminary results from the European network of excellence for big data in prostate cancer (PIONEER)
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Nicoletti, R., primary, Gomez Rivas, J., additional, Ibánez, L., additional, Steinbeisse, C., additional, de Meulder, B., additional, Ayman, H., additional, Golozar, A., additional, Snijder, R., additional, Van Hemelrijck, M., additional, Beyer, K., additional, Willemse, P-P., additional, Murtola, T., additional, Roobol, M.J., additional, Moreno-Sierra, J., additional, Campi, R., additional, Gacci, M., additional, Mottet, N., additional, Merseburger, A., additional, Cornford, P., additional, and Ndow, J., additional
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- 2024
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- View/download PDF
3. Patient- and tumour-related prognostic factors for urinary incontinence after radical prostatectomy for nonmetastatic prostate cancer: A systematic review and meta-analysis
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Grivas, N., primary, Lardas, M., additional, Zattoni, F., additional, Berridge, C., additional, Cumberbatch, M., additional, Van Den Broeck, T., additional, Mottet, N., additional, Tilki, D., additional, and Cornford, P., additional
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- 2024
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- View/download PDF
4. Development of prostate cancer typical case presentations and their usage in OPTIMA’s guideline based decision support tool
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Murray, C., primary, Beyer, K., additional, Gandaglia, G., additional, Stabile, A., additional, Auweter, S., additional, Morariu, A., additional, Santiago, I., additional, Maclennan, S., additional, Thomas, M., additional, Bjartell, A., additional, Cornford, P., additional, Kruger, H., additional, N’dow, J., additional, Roobol, M., additional, and Omar, M.I., additional
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- 2024
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- View/download PDF
5. AGREE II quality assessment of national and international clinical practice guidelines on prostate cancer
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Beyer, K., primary, Bhattacharya, Y., additional, Murray, C., additional, Smith, E.J., additional, Boissier, R., additional, Borkowetz, A., additional, Dabestani, S., additional, Willemse, P-P.M., additional, Maresca, G., additional, Rivas, J.G.M., additional, Rajwa, P., additional, Lardas, M., additional, Grivas, N., additional, Sakalis, V., additional, Evans-Axelsson, S., additional, Maclennan, S., additional, Auweter, S., additional, Thomas, M., additional, Bjartell, A., additional, Cornford, P., additional, Kruger, H., additional, N’dow, J., additional, Roobol, M., additional, and Omar, M.I., additional
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- 2024
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6. OPTIMA prostate cancer care pathways - bridging clinical practice guidelines, real world evidence and artificial intelligence to enhance decision-making
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Anselmo da Costa Santiago, I., primary, Gómez Rivas, J., additional, Maclennan, S., additional, Beyer, K., additional, Murray, C., additional, Smith, E.J., additional, Auweter, S., additional, Thomas, M., additional, Krüger, H., additional, N’dow, J., additional, Bjartell, A., additional, Cornford, P., additional, Roobol, M., additional, and Omar, M.I., additional
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- 2024
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- View/download PDF
7. Prostate cancer detection percentages of repeat biopsy in patients with positive multiparametric MRI (PIRADS/Likert 3-5) and negative initial biopsy. A systematic review
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Grivas, N., primary, Lardas, M., additional, Linares Espinós, E., additional, Lam, T., additional, Rouviere, O., additional, Mottet, N., additional, Van Den Bergh, R., additional, Tilki, D., additional, and Cornford, P., additional
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- 2024
- Full Text
- View/download PDF
8. Systematic review of active surveillance for clinically localized prostate cancer to develop recommendations regarding selection, monitoring and reclassification thresholds
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Willemse, P-P.M., primary, Grivas, N., additional, Zattoni, F., additional, Davis, N.F., additional, Lardas, M., additional, Cornford, P., additional, Mottet, N., additional, and Lam, T.B.L., additional
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- 2022
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9. A novel EAU Guidelines based clinicial decision support software – evaluation of Siemens AIPC Software in prostate cancer screening
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Wetterauer, C., primary, Horn, T., additional, Henkel, M., additional, Leboutte, F., additional, Trotsenko, P., additional, Dugas, S., additional, Sutter, S., additional, Ficht, G., additional, Engesser, C., additional, Matthias, M., additional, Ebbing, J., additional, Stieltjes, B., additional, Cornford, P., additional, Seifert, H.H., additional, and Stalder, A., additional
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- 2022
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10. Evaluation of oncological outcomes and data quality in studies assessing nerve sparing versus non-nerve sparing radical prostatectomy in non-metastatic prostate cancer: A systematic review
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Moris, L., primary, Gandaglia, G., additional, Vilaseca, A., additional, Van Den Broeck, T., additional, Briers, E., additional, De Santis, M., additional, Gillessen, S., additional, Grivas, N., additional, Henry, A., additional, Lam, T.B., additional, Lardas, M., additional, Mason, M., additional, Oprea-Lager, D., additional, Ploussard, G., additional, Rouvière, O., additional, Schoots, I.G., additional, Van Der Poel, H., additional, Wiegel, T., additional, Willemse, P-P., additional, Grummet, J.P., additional, Tilke, D., additional, Van Den Bergh, R.C.N., additional, Cornford, P., additional, and Mottet, N., additional
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- 2021
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- View/download PDF
11. A systematic review on the impact of surgeon and hospital caseload volume on oncological and non-oncological outcomes after radical prostatectomy for non-metastatic prostate cancer
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Van Den Broeck, T., primary, Oprea-Lager, D., additional, Moris, L., additional, Kailavasan, M., additional, Briers, E., additional, Cornford, P., additional, De Santis, M., additional, Gandaglia, G., additional, Gillessen Sommer, S., additional, Grummet, J.P., additional, Grivas, N., additional, Lam, T.B., additional, Lardas, M., additional, Liew, M., additional, Mason, M., additional, O’Hanlon, S., additional, Ploussard, G., additional, Rouvière, O., additional, Schoots, I., additional, Tilki, D., additional, Van Den Bergh, R.C.N., additional, Van Der Poel, H., additional, Wiegel, T., additional, Willemse, P., additional, and Mottet, N., additional
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- 2021
- Full Text
- View/download PDF
12. A1050 - Systematic review of active surveillance for clinically localized prostate cancer to develop recommendations regarding selection, monitoring and reclassification thresholds
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Willemse, P-P.M., Grivas, N., Zattoni, F., Davis, N.F., Lardas, M., Cornford, P., Mottet, N., and Lam, T.B.L.
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- 2022
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13. Ureteroscopic Endopyelotomy with the Holmium:YAG Laser
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Biyani, Chandra Shekhar, Cornford, Philip A., and Powell, Christopher S.
- Abstract
Objective:Various modalities ranging from acucise balloon to endoincision with electrocautery, cold knife, and lasers have been used to treat ureteropelvic junction obstruction (UPJO). We assessed the intermediate effectiveness of endopyelotomy with the holmium(Ho):YAG laser.Patients and Methods:Between November 1994 and May 1998, 20 patients with 16 primary and 4 secondary symptomatic UPJO were treated. All patients were evaluated clinically and radiologically before and after the procedure at 3 months, and yearly thereafter. The mean follow–up was 34 months (12–38 months).Results:A total of 22 procedure were performed on 20 patients with an average operating time of 44.3 min and mean hospital stay of 1.9 days. All patients were stented after the procedure for 6 weeks. Complication included urinoma (1) and guidewire fracture in 1 patient. 15 patients had a successful outcome determined by a diuretic renography and/or Whitaker test. Three patients with poor preoperative renal function (<25%) had an unsatisfactory outcome. There were 2 failures and they were treated with nephrectomy (1) and open pyeloplasty (1).Conclusions:A controlled, precise, safe and almost ‘bloodless’ endopyelotomy can be performed with the holmium laser. Success rate tends to be poor in patients with poor renal function.
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- 2000
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14. A0853 - OPTIMA prostate cancer care pathways - bridging clinical practice guidelines, real world evidence and artificial intelligence to enhance decision-making.
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Anselmo da Costa Santiago, I., Gómez Rivas, J., Maclennan, S., Beyer, K., Murray, C., Smith, E.J., Auweter, S., Thomas, M., Krüger, H., N'dow, J., Bjartell, A., Cornford, P., Roobol, M., and Omar, M.I.
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ARTIFICIAL intelligence , *CANCER treatment , *PROSTATE cancer , *DECISION making , *WATCHFUL waiting - Published
- 2024
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15. A0859 - AGREE II quality assessment of national and international clinical practice guidelines on prostate cancer.
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Beyer, K., Bhattacharya, Y., Murray, C., Smith, E.J., Boissier, R., Borkowetz, A., Dabestani, S., Willemse, P-P.M., Maresca, G., Rivas, J.G.M., Rajwa, P., Lardas, M., Grivas, N., Sakalis, V., Evans-Axelsson, S., Maclennan, S., Auweter, S., Thomas, M., Bjartell, A., and Cornford, P.
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PROSTATE cancer - Published
- 2024
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16. A0852 - Development of prostate cancer typical case presentations and their usage in OPTIMA's guideline based decision support tool.
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Murray, C., Beyer, K., Gandaglia, G., Stabile, A., Auweter, S., Morariu, A., Santiago, I., Maclennan, S., Thomas, M., Bjartell, A., Cornford, P., Kruger, H., N'dow, J., Roobol, M., and Omar, M.I.
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CARCINOGENESIS , *PROSTATE cancer - Published
- 2024
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17. A0643 - Development of a predictive model for death amongst patients with Metastatic Hormone Sensitive Prostate Cancer (mHSPC) treated with one of the approved treatment plans, on characteristics present at admission using Big data: Preliminary results from the European network of excellence for big data in prostate cancer (PIONEER)
- Author
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Nicoletti, R., Gomez Rivas, J., Ibánez, L., Steinbeisse, C., de Meulder, B., Ayman, H., Golozar, A., Snijder, R., Van Hemelrijck, M., Beyer, K., Willemse, P-P., Murtola, T., Roobol, M.J., Moreno-Sierra, J., Campi, R., Gacci, M., Mottet, N., Merseburger, A., Cornford, P., and Ndow, J.
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BIG data , *PROSTATE cancer , *PREDICTION models , *METASTASIS , *HORMONES - Published
- 2024
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18. A0641 - Analysis of clinical characteristics in metastatic hormone-sensitive prostate cancer. A comparative study of patients from cal trials to patients from real life using Big Data.
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Ibanez Vazquez, L., Gómez Rivas, J., Nicoletti, R., Golozar, A., Steinbeißer, C., De Meulder, B., Snijder, R., Axelsson, S.E., Ayman, H., Feng, Q., Bjartell, A., Cornford, P., Murtola, T.J., Willemse, P., Moreno Sierra, J., and N'dow, J.
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BIG data , *PROSTATE cancer , *COMPARATIVE studies , *METASTASIS - Published
- 2024
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19. EAU-EANM-ESTRO-ESUR-SIOG Guidelines on Prostate Cancer. Part II-2020 Update: Treatment of Relapsing and Metastatic Prostate Cancer
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Nicolas Mottet, Lisa Moris, Maria De Santis, Thomas B. Lam, Matthew Liew, Giorgio Gandaglia, Theodorus H. van der Kwast, Nikolaos Grivas, Silke Gillessen, Thomas Van den Broeck, Ann Henry, Philip Cornford, Michael Lardas, Marcus G. Cumberbatch, Nicola Fossati, Erik Briers, Malcolm David Mason, Daniela E. Oprea-Lager, Jeremy Grummet, Thomas Wiegel, Henk G. van der Poel, Ivo G. Schoots, Stefano Fanti, Roderick C.N. van den Bergh, Peter-Paul M. Willemse, Derya Tilki, Olivier Rouvière, Cornford, P., van den Bergh, R. C. N., Briers, E., Van den Broeck, T., Cumberbatch, M. G., De Santis, M., Fanti, S., Fossati, N., Gandaglia, G., Gillessen, S., Grivas, N., Grummet, J., Henry, A. M., der Kwast, T. H. V., Lam, T. B., Lardas, M., Liew, M., Mason, M. D., Moris, L., Oprea-Lager, D. E., der Poel, H. G. V., Rouviere, O., Schoots, I. G., Tilki, D., Wiegel, T., Willemse, P. -P. M., Mottet, N., and Cornford P, van den Bergh RCN, Briers E, Van den Broeck T, Cumberbatch MG, De Santis M, Fanti S, Fossati N, Gandaglia G, Gillessen S, Grivas N, Grummet J, Henry AM, der Kwast THV, Lam TB, Lardas M, Liew M, Mason MD, Moris L, Oprea-Lager DE, der Poel HGV, Rouvière O, Schoots IG, Tilki D, Wiegel T, Willemse PM, Mottet N.
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Biochemical recurrence ,Oncology ,Quality of life ,Male ,medicine.medical_specialty ,Castration resistant ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,urologic and male genital diseases ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Palliative, Prostate cancer, Follow-up ,Internal medicine ,medicine ,Chemotherapy ,Humans ,EAU-EANM-ESTRO-ESUR-SIOG guidelines ,Relapse ,Neoplasm Metastasis ,Palliative ,Prostatectomy ,business.industry ,Follow-up ,Prostatic Neoplasms ,Evidence-based medicine ,Guideline ,medicine.disease ,Radiation therapy ,Geriatric oncology ,030220 oncology & carcinogenesis ,Hormonal therapy ,Metastatic ,Neoplasm Recurrence, Local ,business - Abstract
Objective: To present a summary of the 2020 version of the European Association of Urology (EAU)-European Association of Nuclear Medicine (EANM)-European Society for Radiotherapy & Oncology (ESTRO)-European Society of Urogenital Radiology (ESUR)-International Society of Geriatric Oncology (SIOG) guidelines on the treatment of relapsing, metastatic, and castration-resistant prostate cancer (CRPC). Evidence acquisition: The working panel performed a literature review of the new data (2016–2019). The guidelines were updated, and the levels of evidence and/or grades of recommendation were added based on a systematic review of the literature. Evidence synthesis: Prostate-specific membrane antigen positron emission tomography computed tomography scanning has developed an increasingly important role in men with biochemical recurrence after local therapy. Early salvage radiotherapy after radical prostatectomy appears as effective as adjuvant radiotherapy and, in a subset of patients, should be combined with androgen deprivation. New treatments have become available for men with metastatic hormone-sensitive prostate cancer (PCa), nonmetastatic CRPC, and metastatic CRPC, along with a role for local radiotherapy in men with low-volume metastatic hormone-sensitive PCa. Also included is information on quality of life outcomes in men with PCa. Conclusions: The knowledge in the field of advanced and metastatic PCa and CRPC is changing rapidly. The 2020 EAU-EANM-ESTRO-ESUR-SIOG guidelines on PCa summarise the most recent findings and advice for use in clinical practice. These PCa guidelines are first endorsed by the EANM and reflect the multidisciplinary nature of PCa management. A full version is available from the EAU office or online (http://uroweb.org/guideline/prostate-cancer/). Patient summary: This article summarises the guidelines for the treatment of relapsing, metastatic, and castration-resistant prostate cancer. These guidelines are evidence based and guide the clinician in the discussion with the patient on the treatment decisions to be taken. These guidelines are updated every year; this summary spans the 2017–2020 period of new evidence. The knowledge in the field of advanced and metastatic prostate cancer (PCa) and castration-resistant prostate cancer is changing rapidly. The 2020 European Association of Urology (EAU)-European Association of Nuclear Medicine (EANM)-European Society for Radiotherapy & Oncology (ESTRO)-European Society of Urogenital Radiology (ESUR)-International Society of Geriatric Oncology (SIOG) guidelines on PCa summarise the most recent findings and advice for use in clinical practice. These PCa guidelines are first endorsed by the EANM and reflect the multidisciplinary nature of PCa management. A full version is available from the EAU office or online (http://uroweb.org/guideline/prostate-cancer/).
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- 2020
20. A0855 - Prostate cancer detection percentages of repeat biopsy in patients with positive multiparametric MRI (PIRADS/Likert 3-5) and negative initial biopsy. A systematic review.
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Grivas, N., Lardas, M., Linares Espinós, E., Lam, T., Rouviere, O., Mottet, N., Van Den Bergh, R., Tilki, D., and Cornford, P.
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EARLY detection of cancer , *BIOPSY , *MAGNETIC resonance imaging , *PERCENTILES , *PROSTATE cancer - Published
- 2024
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21. A0856 - Patient- and tumour-related prognostic factors for urinary incontinence after radical prostatectomy for nonmetastatic prostate cancer: A systematic review and meta-analysis.
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Grivas, N., Lardas, M., Zattoni, F., Berridge, C., Cumberbatch, M., Van Den Broeck, T., Mottet, N., Tilki, D., and Cornford, P.
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RADICAL prostatectomy , *URINARY incontinence , *PROGNOSIS , *PROSTATE cancer - Published
- 2024
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22. A0998 - A systematic review to evaluate Patient-Reported Outcomes Measures (PROMs) for metastatic prostate cancer according to the COSMIN methodology – A PIONEER wp2 project.
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Ratti, M.M., Gandaglia, G., Armando, S., Mazzone, E., Scuderi, S., Barletta, F., Mottet, N., Williamson, P.R., Moss, C., Beyer, K., Muhammad Imran, O., Maclennan, S., Zong, J., Cornford, P., Maclennan, S.J., Aiyegbusi, O.L., Van Hemelrijck, M., Alleva, E., Derevianko, A., and Sisca, E.S.
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PATIENT reported outcome measures , *METASTASIS , *PROSTATE cancer - Published
- 2023
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23. A Systematic Review of the Impact of Surgeon and Hospital Caseload Volume on Oncological and Nononcological Outcomes After Radical Prostatectomy for Nonmetastatic Prostate Cancer
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N. Grivas, Guillaume Ploussard, Peter-Paul M. Willemse, Jakub Pecanka, Roderick C.N. van den Bergh, Maria De Santis, Thomas Van den Broeck, Nicolas Mottet, Thomas Wiegel, Olivier Rouvière, Jeremy Grummet, Silke Gillessen Sommer, Mithun Kailavasan, Daniela E. Oprea-Lager, Michael Lardas, Shane O'Hanlon, Cathy Yuhong Yuan, Henk G. van der Poel, Thomas B. Lam, Giorgio Gandaglia, Lisa Moris, Matthew Liew, Derya Tilki, Philip Cornford, Erik Briers, Ivo G. Schoots, Malcolm David Mason, Van den Broeck, T., Oprea-Lager, D., Moris, L., Kailavasan, M., Briers, E., Cornford, P., De Santis, M., Gandaglia, G., Gillessen Sommer, S., Grummet, J. P., Grivas, N., Lam, T. B. L., Lardas, M., Liew, M., Mason, M., O'Hanlon, S., Pecanka, J., Ploussard, G., Rouviere, O., Schoots, I. G., Tilki, D., van den Bergh, R. C. N., van der Poel, H., Wiegel, T., Willemse, P. -P., Yuan, C. Y., and Mottet, N.
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Male ,Biochemical recurrence ,medicine.medical_specialty ,Blood transfusion ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,MEDLINE ,Context (language use) ,Workload ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,SDG 3 - Good Health and Well-being ,Interquartile range ,Outcome Assessment, Health Care ,Oncological outcomes ,Humans ,Medicine ,Prostatectomy ,Surgeons ,Surgeon volume ,business.industry ,General surgery ,Prostate ,Prostatic Neoplasms ,Perioperative ,medicine.disease ,Functional outcomes ,Hospitals ,Hospital volume ,Treatment Outcome ,Evidence synthesis ,030220 oncology & carcinogenesis ,Systematic review ,Neoplasm Recurrence, Local ,business ,Delivery of Health Care ,Hospitals, High-Volume - Abstract
Context The impact of surgeon and hospital volume on outcomes after radical prostatectomy (RP) for localised prostate cancer (PCa) remains unknown. Objective To perform a systematic review on the association between surgeon or hospital volume and oncological and nononcological outcomes following RP for PCa. Evidence acquisition Medline, Medline In-Process, Embase, and the Cochrane Central Register of Controlled Trials were searched. All comparative studies for nonmetastatic PCa patients treated with RP published between January 1990 and May 2020 were included. For inclusion, studies had to compare hospital or surgeon volume, defined as caseload per unit time. Main outcomes included oncological (including prostate-specific antigen persistence, positive surgical margin [PSM], biochemical recurrence, local and distant recurrence, and cancer-specific and overall survival) and nononcological (perioperative complications including need for blood transfusion, conversion to open procedure and within 90-d death, and continence and erectile function) outcomes. Risk of bias (RoB) and confounding assessments were undertaken. Both a narrative and a quantitative synthesis were planned if the data allowed. Evidence synthesis Sixty retrospective comparative studies were included. Generally, increasing surgeon and hospital volumes were associated with lower rates of mortality, PSM, adjuvant or salvage therapies, and perioperative complications. Combining group size cut-offs as used in the included studies, the median threshold for hospital volume at which outcomes start to diverge is 86 (interquartile range [IQR] 35–100) cases per year. In addition, above this threshold, the higher the caseload, the better the outcomes, especially for PSM. RoB and confounding were high for most domains. Conclusions Higher surgeon and hospital volumes for RP are associated with lower rates of PSMs, adjuvant or salvage therapies, and perioperative complications. This association becomes apparent from a caseload of >86 (IQR 35–100) per year and may further improve hereafter. Both high- and low-volume centres should measure their outcomes, make them publicly available, and improve their quality of care if needed. Patient summary We reviewed the literature to determine whether the number of prostate cancer operations (radical prostatectomy) performed in a hospital affects the outcomes of surgery. We found that, overall, hospitals with a higher number of operations per year have better outcomes in terms of cancer recurrence and complications during or after hospitalisation. However, it must be noted that surgeons working in hospitals with lower annual operations can still achieve similar or even better outcomes. Therefore, making hospital’s outcome data publicly available should be promoted internationally, so that patients can make an informed decision where they want to be treated.
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- 2021
24. IMAGINE-IMpact Assessment of Guidelines Implementation and Education: The Next Frontier for Harmonising Urological Practice Across Europe by Improving Adherence to Guidelines
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Philip Cornford, Emma Jane Smith, Steven MacLennan, Nuno Pereira-Azevedo, Monique J. Roobol, Nicolaas Lumen, Louise Fullwood, Eilidh Duncan, Jennifer Dunsmore, Karin Plass, Maria J. Ribal, Thomas Knoll, Anders Bjartell, Hendrick Van Poppel, James N’Dow, Alberto Briganti, Karl Dorfinger, Irene Resch, Mischinger Johannes, Isabel Heidegger, Christophe Assenmacher, Thierry Roumeguère, Karel Decaestecker, Lieven Goeman, Thomas Adams, Marincho Georgiev, Krassimir Yanev, Aleksandar Timev, Igor Tomašković, Tomislav Kuliš, Stavros Charalampous, Dimitris Kontaxis, Marko Babjuk, Roman Zachoval, Tomáš Pitra, Vojtěch Novák, Lars Lund, Martin Kivi, Peep Baum, Toomas Tamm, Pritt Veskimae, Rauno Okas, Kanerva Lahdensuo, Kimmo Taari, Heikki Seikkula, Pyry Jämsä, Xavier Gamé, George Fournier, Alexandre Ingels, Gaelle Fiard, Guillaume Ploussard, Jens Rassweiler, Stefanie Schmidt, Jennifer Kranz, Susanne Krege, Ioannis Gkialas, Anthanasios Dellis, Nikolaos Ferakis, Dionysios Mitropoulos, Peter Ryan, John Paul Sweeney, Eamonn Rogers, Derek Hennessy, Niall. F. Davis, Walter Artibani, Francesco Porpiglia, Salvatore Giuseppe Voce, Maurizio Brausi, Maria A. Cerruto, Francesco Esperto, Matteo Manfredi, Mindaugas Jievaltas, Aušvydas Patašius, Albertas Čekauskas, Stasys Auškalnis, Peter Mulders, Frank Martens, Kathleen W.M. D'Hauwers, Piotr Chlosta, Anna Katarzyna Czech, Katarzyna Gronostaj, Mikołaj Przydacz, Pedro Coelho Nunes, Luís Abranches-Monteiro, Ricardo Pereira e Silva, Frederica Furriel, Pedro Gomes Monteiro, Ioanel Sinescu, Cristian Surcel, Catalin Baston, Robert Ionut Stoica, Vlad Olaru, Boris Kollárik, Ivan Mincik, Ľuboš Rybár, Viktor Kováčik, Ivan Perečinský, Boris Kosuta, Marko Zupancic, Milena Taskovska, Uros Kacjan, Andraz Miklavzina, Manuel Esteban Fuertes, Mario Alvarez-Maestro, Antoni Vilaseca, Rodrigo García-Baquero, Lotta Renström Koskela, Johan Styrke, Gezim Galiqi, Bilbil Hoxha, Evisa Zhapa, Rezart Xhani, Sergey Fanarjyan, Ruben Hovhannisyan, Avoyan E. Armen, Rafael Badalyan, Mustafa Hiroš, Davor Tomić, Damir Aganović, Archil Chkhotua, David Nikoleishvili, Zara Tchanturaia, Sigurdur Gudjónsson, Eirikur Orri Gudmundsson, Rafn Hilmarsson, Emil Ceban, Vitalii Ghicavii, Adrian Tanase, Vladislav Vasiliev, Dragoljub Perovic, Marko Vukovic, Stanisavljevic Rade, Nenad Radovic, Emil Nasufovic, Yuri Alyaev, Igor Korneyev, Sergei Kotov, Vigen Malkhasyan, Dragoslav Basic, Miodrag Aćimović, Saša Vojinov, Aleksandar Vuksanovic, Uroš Bumbaširević, Bojan Čegar, Branko Stanković, Hansjörg Danuser, Tullio Sulser, Valentin Zumstein, Ates Kadioglu, Hakan Kilicarslan, Nusret Can Cilesiz, Erhan Demirelli, Bülent Önal, Aydin Mungan, Serdar Tekgül, Levent Türkeri, Adil Esen, Oleksandr Shulyak, Sergiy Vozianov, Alexandr Shulyak, Serhii Volkov, Andrii Nesterchuk, Urology, Cornford, P., Smith, E. J., Maclennan, S., Pereira-Azevedo, N., Roobol, M. J., Lumen, N., Fullwood, L., Duncan, E., Dunsmore, J., Plass, K., Ribal, M. J., Knoll, T., Bjartell, A., Van Poppel, H., N'Dow, J., and Briganti, A.
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Supplementary data ,Physicians' ,Impact assessment ,business.industry ,Urology ,030232 urology & nephrology ,MEDLINE ,Guideline ,Practice Patterns ,Clinical Practice ,Europe ,Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10] ,03 medical and health sciences ,Frontier ,0302 clinical medicine ,Reconstructive and regenerative medicine Radboud Institute for Molecular Life Sciences [Radboudumc 10] ,Nursing ,030220 oncology & carcinogenesis ,Urological cancers Radboud Institute for Molecular Life Sciences [Radboudumc 15] ,Medicine ,Humans ,Guideline Adherence ,Practice Patterns, Physicians' ,Baseline (configuration management) ,business - Abstract
Contains fulltext : 237261.pdf (Publisher’s version ) (Closed access) Adherence to national and international clinical practice guidelines is suboptimal throughout Europe. The European Association of Urology Guidelines Office project "IMAGINE" (IMpact Assessment of Guidelines Implementation and Education) has been developed to measure baseline adherence to urological guideline recommendations across Europe and to identify issues that drive nonadherence.
- Published
- 2021
25. A0993 - Clinical decision making in prostate cancer care - Evaluation of EAU-guidelines use and novel decision support software.
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Engesser, C., Henkel, M., Stieltjes, B., Fassbind, S., Alargkof, V., Engesser, J., Walter, M., Elyan, A., Studer, J., Sutter, S., Eckert, C., Dugas, S., Hofmann, S., Seifert, H.H., Stalder, A., Cornford, P., and Wetterauer, C.
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DECISION support systems , *DECISION making , *CANCER treatment , *PROSTATE cancer , *UROLOGISTS - Published
- 2023
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26. European Association of Urology Guidelines Office Rapid Reaction Group: An Organisation-wide Collaborative Effort to Adapt the European Association of Urology Guidelines Recommendations to the Coronavirus Disease 2019 Era
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Christopher Harding, Stavros Gravas, Alberto Briganti, Oliver W. Hakenberg, Daniel S. Engeler, Bertil F.M. Blok, Morgan Rouprêt, Börje Ljungberg, Robert Shepherd, Alex Mottrie, James N'Dow, Alberto Breda, Gianluca Giannarini, Noam D. Kitrey, Nick Watkin, Maria P. Laguna, Arnulf Stenzl, J. Alfred Witjes, Marek Babjuk, Evangelos Liatsikos, Nicolaas Lumen, Ali Serdar Gözen, Jens Rassweiler, Nicolas Mottet, Jonathon Olsburgh, Christopher R. Chapple, Christian Türk, Julie Darraugh, Jens Sønksen, Bernardo Rocco, Li Ping Xie, Hendrik Van Poppel, Thomas Knoll, Axel Bex, Giovannalberto Pini, Philip Cornford, Emma Jane Smith, Ramnath Subramaniam, Rizwan Hamid, Gernot Bonkat, Manfred P. Wirth, Christian Radmayr, Nikolaos Sofikitis, Andrea Salonia, Maria J. Ribal, Urology, Biomedical Engineering and Physics, APH - Personalized Medicine, APH - Quality of Care, Ribal, M. J., Cornford, P., Briganti, A., Knoll, T., Gravas, S., Babjuk, M., Harding, C., Breda, A., Bex, A., Rassweiler, J. J., Gozen, A. S., Pini, G., Liatsikos, E., Giannarini, G., Mottrie, A., Subramaniam, R., Sofikitis, N., Rocco, B. M. C., Xie, L. -P., Witjes, J. A., Mottet, N., Ljungberg, B., Roupret, M., Laguna, M. P., Salonia, A., Bonkat, G., Blok, B. F. M., Turk, C., Radmayr, C., Kitrey, N. D., Engeler, D. S., Lumen, N., Hakenberg, O. W., Watkin, N., Hamid, R., Olsburgh, J., Darraugh, J., Shepherd, R., Smith, E. -J., Chapple, C. R., Stenzl, A., Van Poppel, H., Wirth, M., Sonksen, J., and N'Dow, J.
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Urologic Diseases ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Isolation (health care) ,Association (object-oriented programming) ,Urology ,Pneumonia, Viral ,030232 urology & nephrology ,Globe ,Section Offices ,Guidelines ,03 medical and health sciences ,Betacoronavirus ,0302 clinical medicine ,Guidelines recommendations ,Pandemic ,Urological cancers Radboud Institute for Molecular Life Sciences [Radboudumc 15] ,Medicine ,Humans ,Disease management (health) ,Pandemics ,Societies, Medical ,Science & Technology ,Health professionals ,Coronavirus disease 2019 ,business.industry ,SARS-CoV-2 ,COVID-19 ,Disease Management ,Urology & Nephrology ,Europe ,European Association of Urology ,Guidelines Office ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Practice Guidelines as Topic ,business ,Coronavirus Infections ,Life Sciences & Biomedicine - Abstract
Contains fulltext : 220648.pdf (Publisher’s version ) (Closed access) The coronavirus disease 2019 (COVID-19) pandemic is unlike anything seen before by modern science-based medicine. Health systems across the world are struggling to manage it. Added to this struggle are the effects of social confinement and isolation. This brings into question whether the latest guidelines are relevant in this crisis. We aim to support urologists in this difficult situation by providing tools that can facilitate decision making, and to minimise the impact and risks for both patients and health professionals delivering urological care, whenever possible. We hope that the revised recommendations will assist urologist surgeons across the globe to guide the management of urological conditions during the current COVID-19 pandemic.
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- 2020
27. European Association of Urology Guidelines Office: How We Ensure Transparent Conflict of Interest Disclosure and Management
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Julie Darraugh, Thomas Knoll, Alberto Briganti, Maria J. Ribal, Philip Cornford, Emma Jane Smith, Richard Sylvester, Robert Shepherd, Anders Bjartell, Karin Plass, James N'Dow, Nicolaas Lumen, Hendrik Van Poppel, Smith, E. J., Plass, K., Darraugh, J., Shepherd, R., Briganti, A., Cornford, P., Knoll, T., Lumen, N., N'Dow, J., Ribal, M. J., Sylvester, R., van Poppel, H., and Bjartell, A.
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Process management ,Process (engineering) ,business.industry ,Conflict of Interest ,Association (object-oriented programming) ,Urology ,030232 urology & nephrology ,MEDLINE ,Conflict of interest ,Guidelines as Topic ,Disclosure ,Europe ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Medicine ,Humans ,Systematic process ,Guideline development ,business ,Societies, Medical - Abstract
Conflicts of interest (COIs) can potentially introduce a risk of bias into the assessment of evidence and the formulation of recommendations for guidelines. It is essential that a systematic process for the disclosure and management of COIs is adopted to minimise potential bias in the guideline development process.
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- 2019
28. Prostate Cancer Therapy Cardiotoxicity Map (PROXMAP) for Advanced Disease States: A Systematic Review and Network Meta-analysis with Bayesian Modeling of Treatment Histories.
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Aziz MK, Molony D, Monlezun D, Holder T, Brunckhorst O, Higgason N, Roland J, Magill R, Fatakdawala M, Iacobucci A, Mody-Bailey N, Owen C, Zarker A, Thames E, Swaby J, Xiao D, Choi L, Desai S, Galan J, Deng B, Hartshorne T, Nichols A, Zhang A, Imber J, Song J, Jones W, Rivas A, Sanchez D, Guhan M, Gandaglia G, Ranganath S, Jacob J, Howell S, Plana J, van den Bergh R, Roberts M, Sommer SG, Oldenburg J, Ploussard G, Tilki D, Schoots I, Briers E, Stranne J, Rouviere O, van Oort I, Oprea-Lager D, De Santis M, and Cornford P
- Abstract
Background and Objective: Recommendations of first-line therapies for metastatic hormone-sensitive (mHSPC), nonmetastatic castrate-resistant (M0CRPC), and metastatic castrate-resistant (mCRPC) prostate cancer do not account for cardiotoxicity due to a lack of clear prior evidence. This manuscript assesses cardiotoxicity of these therapies., Methods: We searched Ovid Medline, Elsevier Embase, and the Cochrane Library for randomized clinical trials (RCTs) from database inception to January 14, 2024. Network meta-analyses of first-line mHSPC, M0CRPC, and mCRPC therapies were constructed for the five cardiotoxicity metrics defined by the International Cardio-Oncology Society: heart failure, myocarditis, vascular toxicity, hypertension, and arrhythmias. Additional Bayesian network meta-analyses also accounted for prior treatment history., Key Findings and Limitations: Thirteen RCTs (16 292 patients) were included. For mHSPC, androgen deprivation therapy (ADT) plus docetaxel (DTX) plus abiraterone acetate (AA) with prednisone (P) demonstrated a significant increase in hypertension and arrhythmias versus ADT + DTX (risk ratio [RR] 2.85, 95% confidence interval [CI] 1.67-4.89, and RR 2.01, 95% CI 1.17-3.44, respectively); however, no corresponding differences were observed between ADT + DTX plus darolutamide (DAR) and ADT + DTX (RR 1.55, 95% CI 0.73-3.30, and RR 0.94, 95% CI 0.63-1.40, respectively). For mCRPC assuming a history of mHSPC treatment, ADT + AA + P plus olaparib (OLA) demonstrated a statistically significant decrease in hypertension versus ADT + AA + P (RR 0.20, 95% CI 0.16-0.26). M0CRPC results were unremarkable., Conclusions and Clinical Implications: For mHSPC, ADT + DTX + DAR demonstrates less cardiotoxicity than ADT + DTX + AA + P due to a lower risk of hypertension and arrhythmias from decreased mineralocorticoid excess. In addition, OLA counterintuitively offers decreased hypertension when superimposed on ADT + AA + P for mCRPC treatment after prior androgen deprivation from mHSPC therapy., (Copyright © 2024 European Association of Urology. Published by Elsevier B.V. All rights reserved.)
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- 2024
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29. Risk Stratification of Patients with Recurrence After Primary Treatment for Prostate Cancer: A Systematic Review.
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Weiner AB, Kakani P, Armstrong AJ, Bossi A, Cornford P, Feng F, Kanabur P, Karnes RJ, Mckay RR, Morgan TM, Schaeffer EM, Shore N, Tree AC, and Spratt DE
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- Humans, Male, Prognosis, Prostatectomy, Risk Assessment, Risk Factors, Neoplasm Recurrence, Local epidemiology, Prostatic Neoplasms epidemiology, Prostatic Neoplasms pathology, Prostatic Neoplasms therapy
- Abstract
Background and Objective: Biochemical recurrence (BCR) after primary definitive treatment for prostate cancer (PCa) is a heterogeneous disease state. While BCR is associated with worse oncologic outcomes, risk factors that impact outcomes can vary significantly, necessitating avenues for risk stratification. We sought to identify prognostic risk factors at the time of recurrence after primary radical prostatectomy or radiotherapy, and prior to salvage treatment(s), associated with adverse oncologic outcomes., Methods: We performed a systematic review of prospective studies in EMBASE, MEDLINE, and ClinicalTrials.gov (from January 1, 2000 to October 16, 2023) according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines (CRD42023466330). We reviewed the factors associated with oncologic outcomes among patients with BCR after primary definitive treatment., Key Findings and Limitations: A total of 37 studies were included (total n = 10 632), 25 after prostatectomy (total n = 9010) and 12 after radiotherapy (total n = 1622). Following recurrence after prostatectomy, factors associated with adverse outcomes include higher pathologic T stage and grade group, negative surgical margins, shorter prostate-specific antigen doubling time (PSADT), higher prostate-specific antigen (PSA) prior to salvage treatment, shorter time to recurrence, the 22-gene tumor RNA signature, and recurrence location on molecular imaging. After recurrence following radiotherapy, factors associated with adverse outcomes include a shorter time to recurrence, and shorter PSADT or higher PSA velocity. Grade group, T stage, and prior short-term hormone therapy (4-6 mo) were not clearly associated with adverse outcomes, although sample size and follow-up were generally limited compared with postprostatectomy data., Conclusions and Clinical Implications: This work highlights the recommendations and level of evidence for risk stratifying patients with PCa recurrence, and can be used as a benchmark for personalizing salvage treatment based on prognostics., (Copyright © 2024 European Association of Urology. Published by Elsevier B.V. All rights reserved.)
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- 2024
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30. EAU-EANM-ESTRO-ESUR-ISUP-SIOG Guidelines on Prostate Cancer. Part II-2024 Update: Treatment of Relapsing and Metastatic Prostate Cancer.
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Tilki D, van den Bergh RCN, Briers E, Van den Broeck T, Brunckhorst O, Darraugh J, Eberli D, De Meerleer G, De Santis M, Farolfi A, Gandaglia G, Gillessen S, Grivas N, Henry AM, Lardas M, J L H van Leenders G, Liew M, Linares Espinos E, Oldenburg J, van Oort IM, Oprea-Lager DE, Ploussard G, Roberts MJ, Rouvière O, Schoots IG, Schouten N, Smith EJ, Stranne J, Wiegel T, Willemse PM, and Cornford P
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- Humans, Male, Neoplasm Metastasis, Prostatic Neoplasms, Castration-Resistant pathology, Prostatic Neoplasms, Castration-Resistant therapy, Prostatic Neoplasms, Castration-Resistant drug therapy, Neoplasm Recurrence, Local, Prostatic Neoplasms pathology, Prostatic Neoplasms therapy
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Background and Objective: The European Association of Urology (EAU)-European Association of Nuclear Medicine (EANM)-European Society for Radiotherapy and Oncology (ESTRO)-European Society of Urogenital Radiology (ESUR)-International Society of Urological Pathology (ISUP)-International Society of Geriatric Oncology (SIOG) guidelines on the treatment of relapsing, metastatic, and castration-resistant prostate cancer (PCa) have been updated. Here we provide a summary of the 2024 guidelines., Methods: The panel performed a literature review of new data, covering the time frame between 2020 and 2023. The guidelines were updated and a strength rating for each recommendation was added on the basis of a systematic review of the evidence., Key Findings and Limitations: Risk stratification for relapsing PCa after primary therapy may guide salvage therapy decisions. New treatment options, such as androgen receptor-targeted agents (ARTAs), ARTA + chemotherapy combinations, PARP inhibitors and their combinations, and prostate-specific membrane antigen-based therapy have become available for men with metastatic PCa., Conclusions and Clinical Implications: Evidence for relapsing, metastatic, and castration-resistant PCa is evolving rapidly. These guidelines reflect the multidisciplinary nature of PCa management. The full version is available online (http://uroweb.org/guideline/ prostate-cancer/)., Patient Summary: This article summarises the 2024 guidelines for the treatment of relapsing, metastatic, and castration-resistant prostate cancer. These guidelines are based on evidence and guide doctors in discussing treatment decisions with their patients. The guidelines are updated every year., (Copyright © 2024. Published by Elsevier B.V.)
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- 2024
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31. EAU-EANM-ESTRO-ESUR-ISUP-SIOG Guidelines on Prostate Cancer-2024 Update. Part I: Screening, Diagnosis, and Local Treatment with Curative Intent.
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Cornford P, van den Bergh RCN, Briers E, Van den Broeck T, Brunckhorst O, Darraugh J, Eberli D, De Meerleer G, De Santis M, Farolfi A, Gandaglia G, Gillessen S, Grivas N, Henry AM, Lardas M, van Leenders GJLH, Liew M, Linares Espinos E, Oldenburg J, van Oort IM, Oprea-Lager DE, Ploussard G, Roberts MJ, Rouvière O, Schoots IG, Schouten N, Smith EJ, Stranne J, Wiegel T, Willemse PM, and Tilki D
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- Male, Humans, Early Detection of Cancer standards, Prostatic Neoplasms therapy, Prostatic Neoplasms pathology, Prostatic Neoplasms diagnosis
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Background and Objective: The European Association of Urology (EAU)-European Association of Nuclear Medicine (EANM)-European Society for Radiotherapy and Oncology (ESTRO)-European Society of Urogenital Radiology (ESUR)-International Society of Urological Pathology (ISUP)-International Society of Geriatric Oncology (SIOG) guidelines provide recommendations for the management of clinically localised prostate cancer (PCa). This paper aims to present a summary of the 2024 version of the EAU-EANM-ESTRO-ESUR-ISUP-SIOG guidelines on the screening, diagnosis, and treatment of clinically localised PCa., Methods: The panel performed a literature review of all new data published in English, covering the time frame between May 2020 and 2023. The guidelines were updated, and a strength rating for each recommendation was added based on a systematic review of the evidence., Key Findings and Limitations: A risk-adapted strategy for identifying men who may develop PCa is advised, generally commencing at 50 yr of age and based on individualised life expectancy. The use of multiparametric magnetic resonance imaging in order to avoid unnecessary biopsies is recommended. When a biopsy is considered, a combination of targeted and regional biopsies should be performed. Prostate-specific membrane antigen positron emission tomography imaging is the most sensitive technique for identifying metastatic spread. Active surveillance is the appropriate management for men with low-risk PCa, as well as for selected favourable intermediate-risk patients with International Society of Urological Pathology grade group 2 lesions. Local therapies are addressed, as well as the management of persistent prostate-specific antigen after surgery. A recommendation to consider hypofractionation in intermediate-risk patients is provided. Patients with cN1 PCa should be offered a local treatment combined with long-term intensified hormonal treatment., Conclusions and Clinical Implications: The evidence in the field of diagnosis, staging, and treatment of localised PCa is evolving rapidly. These PCa guidelines reflect the multidisciplinary nature of PCa management., Patient Summary: This article is the summary of the guidelines for "curable" prostate cancer. Prostate cancer is "found" through a multistep risk-based screening process. The objective is to find as many men as possible with a curable cancer. Prostate cancer is curable if it resides in the prostate; it is then classified into low-, intermediary-, and high-risk localised and locally advanced prostate cancer. These risk classes are the basis of the treatments. Low-risk prostate cancer is treated with "active surveillance", a treatment with excellent prognosis. For low-intermediary-risk active surveillance should also be discussed as an option. In other cases, active treatments, surgery, or radiation treatment should be discussed along with the potential side effects to allow shared decision-making., (Copyright © 2024 European Association of Urology. Published by Elsevier B.V. All rights reserved.)
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- 2024
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32. Clinical Characterization of Patients Diagnosed with Prostate Cancer and Undergoing Conservative Management: A PIONEER Analysis Based on Big Data.
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Gandaglia G, Pellegrino F, Golozar A, De Meulder B, Abbott T, Achtman A, Imran Omar M, Alshammari T, Areia C, Asiimwe A, Beyer K, Bjartell A, Campi R, Cornford P, Falconer T, Feng Q, Gong M, Herrera R, Hughes N, Hulsen T, Kinnaird A, Lai LYH, Maresca G, Mottet N, Oja M, Prinsen P, Reich C, Remmers S, Roobol MJ, Sakalis V, Seager S, Smith EJ, Snijder R, Steinbeisser C, Thurin NH, Hijazy A, van Bochove K, Van den Bergh RCN, Van Hemelrijck M, Willemse PP, Williams AE, Zounemat Kermani N, Evans-Axelsson S, Briganti A, and N'Dow J
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- Male, Adult, Humans, Big Data, Disease-Free Survival, Europe, Diabetes Mellitus, Type 2, Prostatic Neoplasms therapy, Prostatic Neoplasms diagnosis
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Background: Conservative management is an option for prostate cancer (PCa) patients either with the objective of delaying or even avoiding curative therapy, or to wait until palliative treatment is needed. PIONEER, funded by the European Commission Innovative Medicines Initiative, aims at improving PCa care across Europe through the application of big data analytics., Objective: To describe the clinical characteristics and long-term outcomes of PCa patients on conservative management by using an international large network of real-world data., Design, Setting, and Participants: From an initial cohort of >100 000 000 adult individuals included in eight databases evaluated during a virtual study-a-thon hosted by PIONEER, we identified newly diagnosed PCa cases (n = 527 311). Among those, we selected patients who did not receive curative or palliative treatment within 6 mo from diagnosis (n = 123 146)., Outcome Measurements and Statistical Analysis: Patient and disease characteristics were reported. The number of patients who experienced the main study outcomes was quantified for each stratum and the overall cohort. Kaplan-Meier analyses were used to estimate the distribution of time to event data., Results and Limitations: The most common comorbidities were hypertension (35-73%), obesity (9.2-54%), and type 2 diabetes (11-28%). The rate of PCa-related symptomatic progression ranged between 2.6% and 6.2%. Hospitalization (12-25%) and emergency department visits (10-14%) were common events during the 1st year of follow-up. The probability of being free from both palliative and curative treatments decreased during follow-up. Limitations include a lack of information on patients and disease characteristics and on treatment intent., Conclusions: Our results allow us to better understand the current landscape of patients with PCa managed with conservative treatment. PIONEER offers a unique opportunity to characterize the baseline features and outcomes of PCa patients managed conservatively using real-world data., Patient Summary: Up to 25% of men with prostate cancer (PCa) managed conservatively experienced hospitalization and emergency department visits within the 1st year after diagnosis; 6% experienced PCa-related symptoms. The probability of receiving therapies for PCa decreased according to time elapsed after the diagnosis., (Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)
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- 2024
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33. Reply to Badar M. Mian. Prostate Biopsy: Hyperbole and Misrepresentation Versus Scientific Evidence and Equipoise. Eur Urol. 2024;85:99-100.
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Pilatz A, MacLennan S, van den Bergh RCN, Veeratterapillay R, Imran Omar M, Yuan Y, Cornford P, and Bonkat G
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- Male, Humans, Prostate, Biopsy, Prostatic Neoplasms, Nitrosamines
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- 2024
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34. Impact of Epithelial Histological Types, Subtypes, and Growth Patterns on Oncological Outcomes for Patients with Nonmetastatic Prostate Cancer Treated with Curative Intent: A Systematic Review.
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Marra G, van Leenders GJLH, Zattoni F, Kesch C, Rajwa P, Cornford P, van der Kwast T, van den Bergh RCN, Briers E, Van den Broeck T, De Meerleer G, De Santis M, Eberli D, Farolfi A, Gillessen S, Grivas N, Grummet JP, Henry AM, Lardas M, Lieuw M, Linares Espinós E, Mason MD, O'Hanlon S, van Oort IM, Oprea-Lager DE, Ploussard G, Rouvière O, Schoots IG, Stranne J, Tilki D, Wiegel T, Willemse PM, Mottet N, and Gandaglia G
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- Humans, Male, Prostate surgery, Prostate pathology, Prostate-Specific Antigen, Prostatectomy, Prostatic Intraepithelial Neoplasia, Prostatic Neoplasms pathology
- Abstract
Context: The optimal management for men with prostate cancer (PCa) with unconventional histology (UH) is unknown. The outcome for these cancers might be worse than for conventional PCa and so different approaches may be needed., Objective: To compare oncological outcomes for conventional and UH PCa in men with localized disease treated with curative intent., Evidence Acquisition: A systematic review adhering to the Referred Reporting Items for Systematic Reviews and Meta-Analyses was prospectively registered on PROSPERO (CRD42022296013) was performed in July 2021., Evidence Synthesis: We screened 3651 manuscripts and identified 46 eligible studies (reporting on 1 871 814 men with conventional PCa and 6929 men with 10 different PCa UHs). Extraprostatic extension and lymph node metastases, but not positive margin rates, were more common with UH PCa than with conventional tumors. PCa cases with cribriform pattern, intraductal carcinoma, or ductal adenocarcinoma had higher rates of biochemical recurrence and metastases after radical prostatectomy than for conventional PCa cases. Lower cancer-specific survival rates were observed for mixed cribriform/intraductal and cribriform PCa. By contrast, pathological findings and oncological outcomes for mucinous and prostatic intraepithelial neoplasia (PIN)-like PCa were similar to those for conventional PCa. Limitations of this review include low-quality studies, a risk of reporting bias, and a scarcity of studies that included radiotherapy., Conclusions: Intraductal, cribriform, and ductal UHs may have worse oncological outcomes than for conventional and mucinous or PIN-like PCa. Alternative treatment approaches need to be evaluated in men with these cancers., Patient Summary: We reviewed the literature to explore whether prostate cancers with unconventional growth patterns behave differently to conventional prostate cancers. We found that some unconventional growth patterns have worse outcomes, so we need to investigate if they need different treatments. Urologists should be aware of these growth patterns and their clinical impact., (Copyright © 2023 European Association of Urology. Published by Elsevier B.V. All rights reserved.)
- Published
- 2023
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35. TNM Staging of Prostate Cancer: Challenges in Securing a Globally Applicable Classification.
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Berlin A, Brierley J, Cornford P, Chung P, Giannopoulos E, Mason M, Mottet N, and Gospodarowicz M
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- Humans, Lymphatic Metastasis, Male, Neoplasm Staging, Prognosis, Prostatic Neoplasms pathology
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- 2022
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36. Updating and Integrating Core Outcome Sets for Localised, Locally Advanced, Metastatic, and Nonmetastatic Castration-resistant Prostate Cancer: An Update from the PIONEER Consortium.
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Beyer K, Moris L, Lardas M, Omar MI, Healey J, Tripathee S, Gandaglia G, Venderbos LDF, Vradi E, van den Broeck T, Willemse PP, Antunes-Lopes T, Pacheco-Figueiredo L, Monagas S, Esperto F, Flaherty S, Devecseri Z, Lam TBL, Williamson PR, Heer R, Smith EJ, Asiimwe A, Huber J, Roobol MJ, Zong J, Mason M, Cornford P, Mottet N, MacLennan SJ, N'Dow J, Briganti A, MacLennan S, and Van Hemelrijck M
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- Consensus, Humans, Male, Orchiectomy, Outcome Assessment, Health Care, Prostatic Neoplasms, Castration-Resistant
- Abstract
Context: Harmonisation of outcome reporting and definitions for clinical trials and routine patient records can enable health care systems to provide more efficient outcome-driven and patient-centred interventions. We report on the work of the PIONEER Consortium in this context for prostate cancer (PCa)., Objective: To update and integrate existing core outcome sets (COS) for PCa for the different stages of the disease, assess their applicability, and develop standardised definitions of prioritised outcomes., Evidence Acquisition: We followed a four-stage process involving: (1) systematic reviews; (2) qualitative interviews; (3) expert group meetings to agree standardised terminologies; and (4) recommendations for the most appropriate definitions of clinician-reported outcomes., Evidence Synthesis: Following four systematic reviews, a multinational interview study, and expert group consensus meetings, we defined the most clinically suitable definitions for (1) COS for localised and locally advanced PCa and (2) COS for metastatic and nonmetastatic castration-resistant PCa. No new outcomes were identified in our COS for localised and locally advanced PCa. For our COS for metastatic and nonmetastatic castration-resistant PCa, nine new core outcomes were identified., Conclusions: These are the first COS for PCa for which the definitions of prioritised outcomes have been surveyed in a systematic, transparent, and replicable way. This is also the first time that outcome definitions across all prostate cancer COS have been agreed on by a multidisciplinary expert group and recommended for use in research and clinical practice. To limit heterogeneity across research, these COS should be recommended for future effectiveness trials, systematic reviews, guidelines and clinical practice of localised and metastatic PCa., Patient Summary: Patient outcomes after treatment for prostate cancer (PCa) are difficult to compare because of variability. To allow better use of data from patients with PCa, the PIONEER Consortium has standardised and recommended outcomes (and their definitions) that should be collected as a minimum in all future studies., (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)
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- 2022
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37. Systematic Review of Active Surveillance for Clinically Localised Prostate Cancer to Develop Recommendations Regarding Inclusion of Intermediate-risk Disease, Biopsy Characteristics at Inclusion and Monitoring, and Surveillance Repeat Biopsy Strategy.
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Willemse PM, Davis NF, Grivas N, Zattoni F, Lardas M, Briers E, Cumberbatch MG, De Santis M, Dell'Oglio P, Donaldson JF, Fossati N, Gandaglia G, Gillessen S, Grummet JP, Henry AM, Liew M, MacLennan S, Mason MD, Moris L, Plass K, O'Hanlon S, Omar MI, Oprea-Lager DE, Pang KH, Paterson CC, Ploussard G, Rouvière O, Schoots IG, Tilki D, van den Bergh RCN, Van den Broeck T, van der Kwast TH, van der Poel HG, Wiegel T, Yuan CY, Cornford P, Mottet N, and Lam TBL
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- Biopsy methods, Humans, Image-Guided Biopsy methods, Male, Prostate pathology, Prostate-Specific Antigen, Prostatic Neoplasms pathology, Prostatic Neoplasms therapy, Watchful Waiting methods
- Abstract
Context: There is uncertainty regarding the most appropriate criteria for recruitment, monitoring, and reclassification in active surveillance (AS) protocols for localised prostate cancer (PCa)., Objective: To perform a qualitative systematic review (SR) to issue recommendations regarding inclusion of intermediate-risk disease, biopsy characteristics at inclusion and monitoring, and repeat biopsy strategy., Evidence Acquisition: A protocol-driven, Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA)-adhering SR incorporating AS protocols published from January 1990 to October 2020 was performed. The main outcomes were criteria for inclusion of intermediate-risk disease, monitoring, reclassification, and repeat biopsy strategies (per protocol and/or triggered). Clinical effectiveness data were not assessed., Evidence Synthesis: Of the 17 011 articles identified, 333 studies incorporating 375 AS protocols, recruiting 264 852 patients, were included. Only a minority of protocols included the use of magnetic resonance imaging (MRI) for recruitment (n = 17), follow-up (n = 47), and reclassification (n = 26). More than 50% of protocols included patients with intermediate or high-risk disease, whilst 44.1% of protocols excluded low-risk patients with more than three positive cores, and 39% of protocols excluded patients with core involvement (CI) >50% per core. Of the protocols, ≥80% mandated a confirmatory transrectal ultrasound biopsy; 72% (n = 189) of protocols mandated per-protocol repeat biopsies, with 20% performing this annually and 25% every 2 yr. Only 27 protocols (10.3%) mandated triggered biopsies, with 74% of these protocols defining progression or changes on MRI as triggers for repeat biopsy., Conclusions: For AS protocols in which the use of MRI is not mandatory or absent, we recommend the following: (1) AS can be considered in patients with low-volume International Society of Urological Pathology (ISUP) grade 2 (three or fewer positive cores and cancer involvement ≤50% CI per core) or another single element of intermediate-risk disease, and patients with ISUP 3 should be excluded; (2) per-protocol confirmatory prostate biopsies should be performed within 2 yr, and per-protocol surveillance repeat biopsies should be performed at least once every 3 yr for the first 10 yr; and (3) for patients with low-volume, low-risk disease at recruitment, if repeat systematic biopsies reveal more than three positive cores or maximum CI >50% per core, they should be monitored closely for evidence of adverse features (eg, upgrading); patients with ISUP 2 disease with increased core positivity and/or CI to similar thresholds should be reclassified., Patient Summary: We examined the literature to issue new recommendations on active surveillance (AS) for managing localised prostate cancer. The recommendations include setting criteria for including men with more aggressive disease (intermediate-risk disease), setting thresholds for close monitoring of men with low-risk but more extensive disease, and determining when to perform repeat biopsies (within 2 yr and 3 yearly thereafter)., (Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.)
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- 2022
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38. A Systematic Review of the Impact of Surgeon and Hospital Caseload Volume on Oncological and Nononcological Outcomes After Radical Prostatectomy for Nonmetastatic Prostate Cancer.
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Van den Broeck T, Oprea-Lager D, Moris L, Kailavasan M, Briers E, Cornford P, De Santis M, Gandaglia G, Gillessen Sommer S, Grummet JP, Grivas N, Lam TBL, Lardas M, Liew M, Mason M, O'Hanlon S, Pecanka J, Ploussard G, Rouviere O, Schoots IG, Tilki D, van den Bergh RCN, van der Poel H, Wiegel T, Willemse PP, Yuan CY, and Mottet N
- Subjects
- Delivery of Health Care standards, Hospitals, Hospitals, High-Volume, Humans, Male, Neoplasm Recurrence, Local, Outcome Assessment, Health Care, Treatment Outcome, Workload, Prostate surgery, Prostatectomy adverse effects, Prostatic Neoplasms surgery, Surgeons supply & distribution
- Abstract
Context: The impact of surgeon and hospital volume on outcomes after radical prostatectomy (RP) for localised prostate cancer (PCa) remains unknown., Objective: To perform a systematic review on the association between surgeon or hospital volume and oncological and nononcological outcomes following RP for PCa., Evidence Acquisition: Medline, Medline In-Process, Embase, and the Cochrane Central Register of Controlled Trials were searched. All comparative studies for nonmetastatic PCa patients treated with RP published between January 1990 and May 2020 were included. For inclusion, studies had to compare hospital or surgeon volume, defined as caseload per unit time. Main outcomes included oncological (including prostate-specific antigen persistence, positive surgical margin [PSM], biochemical recurrence, local and distant recurrence, and cancer-specific and overall survival) and nononcological (perioperative complications including need for blood transfusion, conversion to open procedure and within 90-d death, and continence and erectile function) outcomes. Risk of bias (RoB) and confounding assessments were undertaken. Both a narrative and a quantitative synthesis were planned if the data allowed., Evidence Synthesis: Sixty retrospective comparative studies were included. Generally, increasing surgeon and hospital volumes were associated with lower rates of mortality, PSM, adjuvant or salvage therapies, and perioperative complications. Combining group size cut-offs as used in the included studies, the median threshold for hospital volume at which outcomes start to diverge is 86 (interquartile range [IQR] 35-100) cases per year. In addition, above this threshold, the higher the caseload, the better the outcomes, especially for PSM. RoB and confounding were high for most domains., Conclusions: Higher surgeon and hospital volumes for RP are associated with lower rates of PSMs, adjuvant or salvage therapies, and perioperative complications. This association becomes apparent from a caseload of >86 (IQR 35-100) per year and may further improve hereafter. Both high- and low-volume centres should measure their outcomes, make them publicly available, and improve their quality of care if needed., Patient Summary: We reviewed the literature to determine whether the number of prostate cancer operations (radical prostatectomy) performed in a hospital affects the outcomes of surgery. We found that, overall, hospitals with a higher number of operations per year have better outcomes in terms of cancer recurrence and complications during or after hospitalisation. However, it must be noted that surgeons working in hospitals with lower annual operations can still achieve similar or even better outcomes. Therefore, making hospital's outcome data publicly available should be promoted internationally, so that patients can make an informed decision where they want to be treated., (Copyright © 2021. Published by Elsevier B.V.)
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- 2021
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39. Reply to Michael Froehner, Rainer Koch, and Markus Graefen's Letter to the Editor re: Nicolas Mottet, Roderick C.N. van den Bergh, Erik Briers, et al. EAU-EANM-ESTRO-ESUR-SIOG Guidelines on Prostate Cancer-2020 Update. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent. Eur Urol 2021;79:243-62. Comorbidity Measurement in Patients with Prostate Cancer.
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van den Bergh RCN, O'Hanlon S, Cornford P, and Mottet N
- Subjects
- Comorbidity, Humans, Lymphoscintigraphy, Male, Mass Screening, Early Detection of Cancer, Prostatic Neoplasms
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- 2021
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40. IMAGINE-IMpact Assessment of Guidelines Implementation and Education: The Next Frontier for Harmonising Urological Practice Across Europe by Improving Adherence to Guidelines.
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Cornford P, Smith EJ, MacLennan S, Pereira-Azevedo N, Roobol MJ, Lumen N, Fullwood L, Duncan E, Dunsmore J, Plass K, Ribal MJ, Knoll T, Bjartell A, Van Poppel H, N'Dow J, and Briganti A
- Subjects
- Europe, Humans, Guideline Adherence statistics & numerical data, Practice Patterns, Physicians' standards, Urology education
- Abstract
Adherence to national and international clinical practice guidelines is suboptimal throughout Europe. The European Association of Urology Guidelines Office project "IMAGINE" (IMpact Assessment of Guidelines Implementation and Education) has been developed to measure baseline adherence to urological guideline recommendations across Europe and to identify issues that drive nonadherence., (Copyright © 2020 European Association of Urology. Published by Elsevier B.V. All rights reserved.)
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- 2021
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41. EAU-EANM-ESTRO-ESUR-SIOG Guidelines on Prostate Cancer. Part II-2020 Update: Treatment of Relapsing and Metastatic Prostate Cancer.
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Cornford P, van den Bergh RCN, Briers E, Van den Broeck T, Cumberbatch MG, De Santis M, Fanti S, Fossati N, Gandaglia G, Gillessen S, Grivas N, Grummet J, Henry AM, der Kwast THV, Lam TB, Lardas M, Liew M, Mason MD, Moris L, Oprea-Lager DE, der Poel HGV, Rouvière O, Schoots IG, Tilki D, Wiegel T, Willemse PM, and Mottet N
- Subjects
- Humans, Male, Neoplasm Metastasis therapy, Prostatic Neoplasms pathology, Neoplasm Recurrence, Local therapy, Prostatic Neoplasms therapy
- Abstract
Objective: To present a summary of the 2020 version of the European Association of Urology (EAU)-European Association of Nuclear Medicine (EANM)-European Society for Radiotherapy & Oncology (ESTRO)-European Society of Urogenital Radiology (ESUR)-International Society of Geriatric Oncology (SIOG) guidelines on the treatment of relapsing, metastatic, and castration-resistant prostate cancer (CRPC)., Evidence Acquisition: The working panel performed a literature review of the new data (2016-2019). The guidelines were updated, and the levels of evidence and/or grades of recommendation were added based on a systematic review of the literature., Evidence Synthesis: Prostate-specific membrane antigen positron emission tomography computed tomography scanning has developed an increasingly important role in men with biochemical recurrence after local therapy. Early salvage radiotherapy after radical prostatectomy appears as effective as adjuvant radiotherapy and, in a subset of patients, should be combined with androgen deprivation. New treatments have become available for men with metastatic hormone-sensitive prostate cancer (PCa), nonmetastatic CRPC, and metastatic CRPC, along with a role for local radiotherapy in men with low-volume metastatic hormone-sensitive PCa. Also included is information on quality of life outcomes in men with PCa., Conclusions: The knowledge in the field of advanced and metastatic PCa and CRPC is changing rapidly. The 2020 EAU-EANM-ESTRO-ESUR-SIOG guidelines on PCa summarise the most recent findings and advice for use in clinical practice. These PCa guidelines are first endorsed by the EANM and reflect the multidisciplinary nature of PCa management. A full version is available from the EAU office or online (http://uroweb.org/guideline/prostate-cancer/)., Patient Summary: This article summarises the guidelines for the treatment of relapsing, metastatic, and castration-resistant prostate cancer. These guidelines are evidence based and guide the clinician in the discussion with the patient on the treatment decisions to be taken. These guidelines are updated every year; this summary spans the 2017-2020 period of new evidence., (Copyright © 2020. Published by Elsevier B.V.)
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- 2021
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42. EAU-EANM-ESTRO-ESUR-SIOG Guidelines on Prostate Cancer-2020 Update. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent.
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Mottet N, van den Bergh RCN, Briers E, Van den Broeck T, Cumberbatch MG, De Santis M, Fanti S, Fossati N, Gandaglia G, Gillessen S, Grivas N, Grummet J, Henry AM, van der Kwast TH, Lam TB, Lardas M, Liew M, Mason MD, Moris L, Oprea-Lager DE, van der Poel HG, Rouvière O, Schoots IG, Tilki D, Wiegel T, Willemse PM, and Cornford P
- Subjects
- Humans, Male, Early Detection of Cancer, Prostatic Neoplasms diagnosis, Prostatic Neoplasms therapy
- Abstract
Objective: To present a summary of the 2020 version of the European Association of Urology (EAU)-European Association of Nuclear Medicine (EANM)-European Society for Radiotherapy and Oncology (ESTRO)-European Society of Urogenital Radiology (ESUR)-International Society of Geriatric Oncology (SIOG) guidelines on screening, diagnosis, and local treatment of clinically localised prostate cancer (PCa)., Evidence Acquisition: The panel performed a literature review of new data, covering the time frame between 2016 and 2020. The guidelines were updated and a strength rating for each recommendation was added based on a systematic review of the evidence., Evidence Synthesis: A risk-adapted strategy for identifying men who may develop PCa is advised, generally commencing at 50 yr of age and based on individualised life expectancy. Risk-adapted screening should be offered to men at increased risk from the age of 45 yr and to breast cancer susceptibility gene (BRCA) mutation carriers, who have been confirmed to be at risk of early and aggressive disease (mainly BRAC2), from around 40 yr of age. The use of multiparametric magnetic resonance imaging in order to avoid unnecessary biopsies is recommended. When a biopsy is performed, a combination of targeted and systematic biopsies must be offered. There is currently no place for the routine use of tissue-based biomarkers. Whilst prostate-specific membrane antigen positron emission tomography computed tomography is the most sensitive staging procedure, the lack of outcome benefit remains a major limitation. Active surveillance (AS) should always be discussed with low-risk patients, as well as with selected intermediate-risk patients with favourable International Society of Urological Pathology (ISUP) 2 lesions. Local therapies are addressed, as well as the AS journey and the management of persistent prostate-specific antigen after surgery. A strong recommendation to consider moderate hypofractionation in intermediate-risk patients is provided. Patients with cN1 PCa should be offered a local treatment combined with long-term hormonal treatment., Conclusions: The evidence in the field of diagnosis, staging, and treatment of localised PCa is evolving rapidly. The 2020 EAU-EANM-ESTRO-ESUR-SIOG guidelines on PCa summarise the most recent findings and advice for their use in clinical practice. These PCa guidelines reflect the multidisciplinary nature of PCa management., Patient Summary: Updated prostate cancer guidelines are presented, addressing screening, diagnosis, and local treatment with curative intent. These guidelines rely on the available scientific evidence, and new insights will need to be considered and included on a regular basis. In some cases, the supporting evidence for new treatment options is not yet strong enough to provide a recommendation, which is why continuous updating is important. Patients must be fully informed of all relevant options and, together with their treating physicians, decide on the most optimal management for them., (Copyright © 2020. Published by Elsevier B.V.)
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- 2021
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43. Precision Oncology for Metastatic Prostate Cancer: Translation into Practice.
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De Santis M, Mottet N, Cornford P, and Gillessen S
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- Humans, Male, Translational Research, Biomedical, Medical Oncology methods, Precision Medicine, Prostatic Neoplasms drug therapy
- Abstract
While the principles of precision medicine have been readily embraced by all stakeholders, multiple conceptional and structural challenges hinder its broad implementation in clinical practice. PROfound provides the highest level of evidence for the use of a poly(adenosine diphosphate-ribose) polymerase inhibitor in prostate cancer so far. It is an undoubtedly positive trial, but it also clearly shows the complexity of precision oncology for prostate cancer and the challenges of translating genomics into treatment for metastatic castration-resistant disease., (Copyright © 2020 European Association of Urology. Published by Elsevier B.V. All rights reserved.)
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- 2020
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44. Prostate-specific Membrane Antigen Positron Emission Tomography Scans Before Curative Treatment: Ready for Prime Time?
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Cornford P, Grummet J, and Fanti S
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- Humans, Male, Antigens, Surface, Glutamate Carboxypeptidase II, Positron-Emission Tomography methods, Prostatic Neoplasms diagnostic imaging
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- 2020
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45. European Association of Urology Guidelines Office Rapid Reaction Group: An Organisation-wide Collaborative Effort to Adapt the European Association of Urology Guidelines Recommendations to the Coronavirus Disease 2019 Era.
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Ribal MJ, Cornford P, Briganti A, Knoll T, Gravas S, Babjuk M, Harding C, Breda A, Bex A, Rassweiler JJ, Gözen AS, Pini G, Liatsikos E, Giannarini G, Mottrie A, Subramaniam R, Sofikitis N, Rocco BMC, Xie LP, Witjes JA, Mottet N, Ljungberg B, Rouprêt M, Laguna MP, Salonia A, Bonkat G, Blok BFM, Türk C, Radmayr C, Kitrey ND, Engeler DS, Lumen N, Hakenberg OW, Watkin N, Hamid R, Olsburgh J, Darraugh J, Shepherd R, Smith EJ, Chapple CR, Stenzl A, Van Poppel H, Wirth M, Sønksen J, and N'Dow J
- Subjects
- COVID-19, Coronavirus Infections complications, Europe, Humans, Pandemics, Pneumonia, Viral complications, SARS-CoV-2, Urologic Diseases complications, Urologic Diseases diagnosis, Betacoronavirus, Coronavirus Infections epidemiology, Disease Management, Pneumonia, Viral epidemiology, Practice Guidelines as Topic, Societies, Medical, Urologic Diseases therapy, Urology standards
- Abstract
The coronavirus disease 2019 (COVID-19) pandemic is unlike anything seen before by modern science-based medicine. Health systems across the world are struggling to manage it. Added to this struggle are the effects of social confinement and isolation. This brings into question whether the latest guidelines are relevant in this crisis. We aim to support urologists in this difficult situation by providing tools that can facilitate decision making, and to minimise the impact and risks for both patients and health professionals delivering urological care, whenever possible. We hope that the revised recommendations will assist urologist surgeons across the globe to guide the management of urological conditions during the current COVID-19 pandemic., (Copyright © 2020. Published by Elsevier B.V.)
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- 2020
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46. Benefits and Risks of Primary Treatments for High-risk Localized and Locally Advanced Prostate Cancer: An International Multidisciplinary Systematic Review.
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Moris L, Cumberbatch MG, Van den Broeck T, Gandaglia G, Fossati N, Kelly B, Pal R, Briers E, Cornford P, De Santis M, Fanti S, Gillessen S, Grummet JP, Henry AM, Lam TBL, Lardas M, Liew M, Mason MD, Omar MI, Rouvière O, Schoots IG, Tilki D, van den Bergh RCN, van Der Kwast TH, van Der Poel HG, Willemse PM, Yuan CY, Konety B, Dorff T, Jain S, Mottet N, and Wiegel T
- Subjects
- Humans, Internationality, Male, Neoplasm Metastasis, Neoplasm Staging, Prostatic Neoplasms pathology, Prostatic Neoplasms therapy, Risk Assessment
- Abstract
Context: The optimal treatment for men with high-risk localized or locally advanced prostate cancer (PCa) remains unknown., Objective: To perform a systematic review of the existing literature on the effectiveness of the different primary treatment modalities for high-risk localized and locally advanced PCa. The primary oncological outcome is the development of distant metastases at ≥5 yr of follow-up. Secondary oncological outcomes are PCa-specific mortality, overall mortality, biochemical recurrence, and need for salvage treatment with ≥5 yr of follow-up. Nononcological outcomes are quality of life (QoL), functional outcomes, and treatment-related side effects reported., Evidence Acquisition: Medline, Medline In-Process, Embase, and the Cochrane Central Register of Randomized Controlled Trials were searched. All comparative (randomized and nonrandomized) studies published between January 2000 and May 2019 with at least 50 participants in each arm were included. Studies reporting on high-risk localized PCa (International Society of Urologic Pathologists [ISUP] grade 4-5 [Gleason score {GS} 8-10] or prostate-specific antigen [PSA] >20 ng/ml or ≥ cT2c) and/or locally advanced PCa (any PSA, cT3-4 or cN+, any ISUP grade/GS) or where subanalyses were performed on either group were included. The following primary local treatments were mandated: radical prostatectomy (RP), external beam radiotherapy (EBRT) (≥64 Gy), brachytherapy (BT), or multimodality treatment combining any of the local treatments above (±any systemic treatment). Risk of bias (RoB) and confounding factors were assessed for each study. A narrative synthesis was performed., Evidence Synthesis: Overall, 90 studies met the inclusion criteria. RoB and confounding factors revealed high RoB for selection, performance, and detection bias, and low RoB for correction of initial PSA and biopsy GS. When comparing RP with EBRT, retrospective series suggested an advantage for RP, although with a low level of evidence. Both RT and RP should be seen as part of a multimodal treatment plan with possible addition of (postoperative) RT and/or androgen deprivation therapy (ADT), respectively. High levels of evidence exist for EBRT treatment, with several randomized clinical trials showing superior outcome for adding long-term ADT or BT to EBRT. No clear cutoff can be proposed for RT dose, but higher RT doses by means of dose escalation schemes result in an improved biochemical control. Twenty studies reported data on QoL, with RP resulting mainly in genitourinary toxicity and sexual dysfunction, and EBRT in bowel problems., Conclusions: Based on the results of this systematic review, both RP as part of multimodal treatment and EBRT + long-term ADT can be recommended as primary treatment in high-risk and locally advanced PCa. For high-risk PCa, EBRT + BT can also be offered despite more grade 3 toxicity. Interestingly, for selected patients, for example, those with higher comorbidity, a shorter duration of ADT might be an option. For locally advanced PCa, EBRT + BT shows promising result but still needs further validation. In this setting, it is important that patients are aware that the offered therapy will most likely be in the context a multimodality treatment plan. In particular, if radiation is used, the combination of local with systemic treatment provides the best outcome, provided the patient is fit enough to receive both. Until the results of the SPCG15 trial are known, the optimal local treatment remains a matter of debate. Patients should at all times be fully informed about all available options, and the likelihood of a multimodal approach including the potential side effects of both local and systemic treatment., Patient Summary: We reviewed the literature to see whether the evidence from clinical studies would tell us the best way of curing men with aggressive prostate cancer that had not spread to other parts of the body such as lymph glands or bones. Based on the results of this systematic review, there is good evidence that both surgery and radiation therapy are good treatment options, in terms of prolonging life and preserving quality of life, provided they are combined with other treatments. In the case of surgery this means including radiotherapy (RT), and in the case of RT this means either hormonal therapy or combined RT and brachytherapy., (Copyright © 2020 European Association of Urology. Published by Elsevier B.V. All rights reserved.)
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- 2020
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47. European Association of Urology Guidelines Office: How We Ensure Transparent Conflict of Interest Disclosure and Management.
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Smith EJ, Plass K, Darraugh J, Shepherd R, Briganti A, Cornford P, Knoll T, Lumen N, N'Dow J, Ribal MJ, Sylvester R, van Poppel H, and Bjartell A
- Subjects
- Europe, Guidelines as Topic, Humans, Societies, Medical, Urology, Conflict of Interest, Disclosure
- Abstract
Conflicts of interest (COIs) can potentially introduce a risk of bias into the assessment of evidence and the formulation of recommendations for guidelines. It is essential that a systematic process for the disclosure and management of COIs is adopted to minimise potential bias in the guideline development process., (Copyright © 2020 European Association of Urology. Published by Elsevier B.V. All rights reserved.)
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- 2020
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48. EAU-EANM-ESTRO-ESUR-SIOG Prostate Cancer Guideline Panel Consensus Statements for Deferred Treatment with Curative Intent for Localised Prostate Cancer from an International Collaborative Study (DETECTIVE Study).
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Lam TBL, MacLennan S, Willemse PM, Mason MD, Plass K, Shepherd R, Baanders R, Bangma CH, Bjartell A, Bossi A, Briers E, Briganti A, Buddingh KT, Catto JWF, Colecchia M, Cox BW, Cumberbatch MG, Davies J, Davis NF, De Santis M, Dell'Oglio P, Deschamps A, Donaldson JF, Egawa S, Fankhauser CD, Fanti S, Fossati N, Gandaglia G, Gillessen S, Grivas N, Gross T, Grummet JP, Henry AM, Ingels A, Irani J, Lardas M, Liew M, Lin DW, Moris L, Omar MI, Pang KH, Paterson CC, Renard-Penna R, Ribal MJ, Roobol MJ, Rouprêt M, Rouvière O, Sancho Pardo G, Richenberg J, Schoots IG, Sedelaar JPM, Stricker P, Tilki D, Vahr Lauridsen S, van den Bergh RCN, Van den Broeck T, van der Kwast TH, van der Poel HG, van Leenders GJLH, Varma M, Violette PD, Wallis CJD, Wiegel T, Wilkinson K, Zattoni F, N'Dow JMO, Van Poppel H, Cornford P, and Mottet N
- Subjects
- Humans, Male, Prostatic Neoplasms pathology, Time-to-Treatment, Prostatic Neoplasms therapy
- Abstract
Background: There is uncertainty in deferred active treatment (DAT) programmes, regarding patient selection, follow-up and monitoring, reclassification, and which outcome measures should be prioritised., Objective: To develop consensus statements for all domains of DAT., Design, Setting, and Participants: A protocol-driven, three phase study was undertaken by the European Association of Urology (EAU)-European Association of Nuclear Medicine (EANM)-European Society for Radiotherapy and Oncology (ESTRO)-European Association of Urology Section of Urological Research (ESUR)-International Society of Geriatric Oncology (SIOG) Prostate Cancer Guideline Panel in conjunction with partner organisations, including the following: (1) a systematic review to describe heterogeneity across all domains; (2) a two-round Delphi survey involving a large, international panel of stakeholders, including healthcare practitioners (HCPs) and patients; and (3) a consensus group meeting attended by stakeholder group representatives. Robust methods regarding what constituted the consensus were strictly followed., Results and Limitations: A total of 109 HCPs and 16 patients completed both survey rounds. Of 129 statements in the survey, consensus was achieved in 66 (51%); the rest of the statements were discussed and voted on in the consensus meeting by 32 HCPs and three patients, where consensus was achieved in additional 27 statements (43%). Overall, 93 statements (72%) achieved consensus in the project. Some uncertainties remained regarding clinically important thresholds for disease extent on biopsy in low-risk disease, and the role of multiparametric magnetic resonance imaging in determining disease stage and aggressiveness as a criterion for inclusion and exclusion., Conclusions: Consensus statements and the findings are expected to guide and inform routine clinical practice and research, until higher levels of evidence emerge through prospective comparative studies and clinical trials., Patient Summary: We undertook a project aimed at standardising the elements of practice in active surveillance programmes for early localised prostate cancer because currently there is great variation and uncertainty regarding how best to conduct them. The project involved large numbers of healthcare practitioners and patients using a survey and face-to-face meeting, in order to achieve agreement (ie, consensus) regarding best practice, which will provide guidance to clinicians and researchers., (Copyright © 2019. Published by Elsevier B.V.)
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- 2019
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49. Prognostic Value of Biochemical Recurrence Following Treatment with Curative Intent for Prostate Cancer: A Systematic Review.
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Van den Broeck T, van den Bergh RCN, Arfi N, Gross T, Moris L, Briers E, Cumberbatch M, De Santis M, Tilki D, Fanti S, Fossati N, Gillessen S, Grummet JP, Henry AM, Lardas M, Liew M, Rouvière O, Pecanka J, Mason MD, Schoots IG, van Der Kwast TH, van Der Poel HG, Wiegel T, Willemse PM, Yuan Y, Lam TB, Cornford P, and Mottet N
- Subjects
- Humans, Male, Neoplasm Recurrence, Local mortality, Prognosis, Prostatic Neoplasms mortality, Survival Rate, Kallikreins blood, Neoplasm Recurrence, Local blood, Prostate-Specific Antigen blood, Prostatic Neoplasms blood
- Abstract
Context: In men with prostate cancer (PCa) treated with curative intent, controversy exists regarding the impact of biochemical recurrence (BCR) on oncological outcomes., Objective: To perform a systematic review of the existing literature on BCR after treatment with curative intent for nonmetastatic PCa. Objective 1 is to investigate whether oncological outcomes differ between patients with or without BCR. Objective 2 is to study which clinical factors and tumor features in patients with BCR have an independent prognostic impact on oncological outcomes., Evidence Acquisition: Medline, Medline In-Process, Embase, and the Cochrane Central Register of Controlled Trials were searched. For objective 1, prospective and retrospective studies comparing survival outcomes of patients with or without BCR following radical prostatectomy (RP) or radical radiotherapy (RT) were included. For objective 2, all studies with at least 100 participants and reporting on prognostic patient and tumor characteristics in patients with BCR were included. Risk-of-bias and confounding assessments were performed according to the Quality in Prognosis Studies tool. Both a narrative synthesis and a meta-analysis were undertaken., Evidence Synthesis: Overall, 77 studies were included for analysis, of which 14 addressed objective 1, recruiting 20 406 patients. Objective 2 was addressed by 71 studies with 29 057, 11 301, and 4272 patients undergoing RP, RT, and a mixed population (mix of patients undergoing RP or RT as primary treatment), respectively. There was a low risk of bias for study participation, confounders, and statistical analysis. For most studies, attrition bias, and prognostic and outcome measurements were not clearly reported. BCR was associated with worse survival rates, mainly in patients with short prostate-specific antigen doubling time (PSA-DT) and a high final Gleason score after RP, or a short interval to biochemical failure (IBF) after RT and a high biopsy Gleason score., Conclusions: BCR has an impact on survival, but this effect appears to be limited to a subgroup of patients with specific clinical risk factors. Short PSA-DT and a high final Gleason score after RP, and a short IBF after RT and a high biopsy Gleason score are the main factors that have a negative impact on survival. These factors may form the basis of new BCR risk stratification (European Association of Urology BCR Risk Groups), which needs to be validated formally., Patient Summary: This review looks at the risk of death in men who shows rising prostate-specific antigen (PSA) in the blood test performed after curative surgery or radiotherapy. For many men, rising PSA does not mean that they are at a high risk of death from prostate cancer in the longer term. Men with PSA that rises shortly after they were treated with radiotherapy or rapidly rising PSA after surgery and a high tumor grade for both treatment modalities are at the highest risk of death. These factors may form the basis of new risk stratification (European Association of Urology biochemical recurrence Risk Groups), which needs to be validated formally., (Copyright © 2018 European Association of Urology. Published by Elsevier B.V. All rights reserved.)
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- 2019
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50. Study Protocol for the DETECTIVE Study: An International Collaborative Study To Develop Consensus Statements for Deferred Treatment with Curative Intent for Localised Prostate Cancer.
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Lam TBL, MacLennan S, Plass K, Willemse PM, Mason MD, Cornford P, Donaldson J, Davis NF, Dell'Oglio P, Fankhauser C, Grivas N, Ingels A, Lardas M, Liew M, Pang KH, Paterson C, Omar MI, Zattoni F, Buddingh KT, Van den Broeck T, Cumberbatch MG, Fossati N, Gross T, Moris L, Schoots IG, van den Bergh RCN, Briers E, Fanti S, De Santis M, Gillessen S, Grummet JP, Henry AM, van der Poel HG, van der Kwast TH, Rouvière O, Tilki D, Wiegel T, N'Dow J, Van Poppel H, and Mottet N
- Subjects
- Consensus, Consensus Development Conferences as Topic, Delphi Technique, Evidence-Based Medicine, Humans, Male, Prostatic Neoplasms pathology, Systematic Reviews as Topic, Treatment Outcome, Medical Oncology standards, Multicenter Studies as Topic methods, Prostatic Neoplasms therapy, Research Design, Urology standards
- Published
- 2019
- Full Text
- View/download PDF
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