BACKGROUND In advanced prostate cancer (APC), successful drug development as well as advances in imaging and molecular characterisation have resulted in multiple areas where there is lack of evidence or low level of evidence. The Advanced Prostate Cancer Consensus Conference (APCCC) 2017 addressed some of these topics. OBJECTIVE To present the report of APCCC 2017. DESIGN, SETTING, AND PARTICIPANTS Ten important areas of controversy in APC management were identified: high-risk localised and locally advanced prostate cancer; "oligometastatic" prostate cancer; castration-naïve and castration-resistant prostate cancer; the role of imaging in APC; osteoclast-targeted therapy; molecular characterisation of blood and tissue; genetic counselling/testing; side effects of systemic treatment(s); global access to prostate cancer drugs. A panel of 60 international prostate cancer experts developed the program and the consensus questions. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS The panel voted publicly but anonymously on 150 predefined questions, which have been developed following a modified Delphi process. RESULTS AND LIMITATIONS Voting is based on panellist opinion, and thus is not based on a standard literature review or meta-analysis. The outcomes of the voting had varying degrees of support, as reflected in the wording of this article, as well as in the detailed voting results recorded in Supplementary data. CONCLUSIONS The presented expert voting results can be used for support in areas of management of men with APC where there is no high-level evidence, but individualised treatment decisions should as always be based on all of the data available, including disease extent and location, prior therapies regardless of type, host factors including comorbidities, as well as patient preferences, current and emerging evidence, and logistical and economic constraints. Inclusion of men with APC in clinical trials should be strongly encouraged. Importantly, APCCC 2017 again identified important areas in need of trials specifically designed to address them. PATIENT SUMMARY The second Advanced Prostate Cancer Consensus Conference APCCC 2017 did provide a forum for discussion and debates on current treatment options for men with advanced prostate cancer. The aim of the conference is to bring the expertise of world experts to care givers around the world who see less patients with prostate cancer. The conference concluded with a discussion and voting of the expert panel on predefined consensus questions, targeting areas of primary clinical relevance. The results of these expert opinion votes are embedded in the clinical context of current treatment of men with advanced prostate cancer and provide a practical guide to clinicians to assist in the discussions with men with prostate cancer as part of a shared and multidisciplinary decision-making process.

中文翻译：

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晚期前列腺癌患者的管理：2017 年 APCCC 晚期前列腺癌共识会议报告。


背景技术在晚期前列腺癌（APC）中，药物开发的成功以及成像和分子表征的进步导致多个领域缺乏证据或证据水平较低。 2017 年晚期前列腺癌共识会议 (APCCC) 讨论了其中一些主题。目的 提交 2017 年 APCCC 报告。 设计、背景和参与者 确定了 APC 管理中十大重要争议领域：高危局部和局部晚期前列腺癌； “寡转移性”前列腺癌；未曾去势的前列腺癌和去势抵抗性前列腺癌；成像在 APC 中的作用；破骨细胞靶向治疗；血液和组织的分子特征；遗传咨询/检测；全身治疗的副作用；全球范围内可获得前列腺癌药物。由 60 名国际前列腺癌专家组成的小组制定了该计划和共识问题。结果测量和统计分析 小组对 150 个预定义问题进行了公开但匿名的投票，这些问题是根据修改后的德尔菲流程制定的。结果和局限性 投票基于小组成员的意见，因此不是基于标准的文献综述或荟萃分析。投票结果得到了不同程度的支持，正如本文的措辞以及补充数据中记录的详细投票结果所反映的那样。 结论 所提出的专家投票结果可用于支持没有高级证据的 APC 男性管理领域，但个体化治疗决策应始终基于所有可用数据，包括疾病范围和位置，既往治疗（无论类型）、宿主因素（包括合并症）、患者偏好、当前和新出现的证据以及后勤和经济限制。应大力鼓励将患有 APC 的男性纳入临床试验。重要的是，2017 年 APCCC 再次确定了需要专门进行试验来解决这些问题的重要领域。患者摘要 2017 年第二届晚期前列腺癌共识会议 APCCC 确实为晚期前列腺癌男性当前治疗方案的讨论和辩论提供了一个论坛。此次会议的目的是将世界专家的专业知识带给世界各地前列腺癌患者较少的护理人员。会议结束时，专家小组针对主要临床相关领域的预先确定的共识问题进行了讨论和投票。这些专家意见投票的结果融入了当前治疗晚期前列腺癌男性的临床背景，并为临床医生提供了实用指南，以协助与前列腺癌男性进行讨论，作为共享和多学科决策过程的一部分。