Management of patients with advanced prostate cancer: Report of the Taiwan Advanced Prostate Cancer Consensus Conference 2022

The landscape for advanced prostate cancer has significantly evolved over the past decade. However, there remains a notable lack of robust evidence across various facets of clinical practice. The Taiwan Urological Association organized the 2022 Taiwan Advanced Prostate Cancer Consensus Conference (TAPCCC) to address specific topics designed to augment existing guidelines. The TAPCCC 2022 questionnaire was designed based on the Advanced Prostate Cancer Consensus Conference 2022 held by the Advanced Prostate Cancer Society and tailored to regional characteristics and medical practice in Taiwan. The questionnaire involved 7 areas of advanced prostate cancer: high-risk and locally advanced prostate cancer, biochemical recurrence, management of metastatic hormone-sensitive prostate cancer, management of nonmetastatic castration-resistant prostate cancer, importance of lifestyle and prevention of complications in advanced prostate cancer, management of metastatic castration-resistant prostate cancer, and oligometastatic and oligoprogressive prostate cancer. The panel experts voted anonymously on 93 predefined questions before and after the conference following a modified Delphi process. A consensus was defined as ≥75% agreement of answer options and strong consensus was defined as ≥90% agreement of answer options. A total of 61 Taiwanese panel experts were involved. Of the 93 questions asked, 40 (43.0%) achieved consensus and 14 (15.1%) reached a strong consensus. In addition, 18 questions (19.4%) demonstrated a ≥75% agreement while combining answer options. The voting results were presented alongside the most recent guidelines and evidence found in the literature, a detailed report of which is included in Supplementary Materials, http://links.lww.com/URSC/A51. In conclusion, the TAPCCC 2022 successfully identified salient issues, and the consensus answer options arising from the conference merit thorough evaluation for integration into clinical practice. The voting results offer guidance for clinicians navigating the management of advanced prostate cancer, particularly in situations where there is a paucity of robust evidence.