A modified Delphi study to develop a practical guide for selecting patients with prostate cancer for active...

Area of Science:

• Oncology
• Urology
• Clinical Practice Guidelines

Background:

• Active surveillance (AS) is a management option for low-risk prostate cancer.
• International variation exists in AS protocols, lacking evidence for optimal approaches.
• Guidance for clinicians is needed to standardize AS practices.

Purpose of the Study:

• To establish international expert consensus on patient selection for active surveillance in prostate cancer.
• To provide evidence-based guidance for clinicians managing low-risk prostate cancer.

Main Methods:

• Modified Delphi approach with online questionnaires and a face-to-face workshop.
• International panel of 12 prostate cancer experts.
• 7-point Likert scale for agreement on AS patient selection criteria.

Main Results:

• Consensus reached on minimum diagnostic tests: PSA, PSA density, Multiparametric MRI, and biopsy (systematic and/or targeted).
• Agreement on patient factors and clinical parameters for AS suitability.
• Genetic and genomic testing not recommended for AS clinical decision-making.

Conclusions:

• International AS practice for low-risk prostate cancer shows inconsistency.
• Areas of common practice identified to inform clinical decision-making.
• Consensus provides a foundation for optimizing AS outcomes.