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Rodriguez-Sanchez L, Cathelineau X, de Reijke TM, Stricker P, Emberton M, Lantz A, Miñana López B, Dominguez-Escrig JL, Bianco FJ, Salomon G, Haider A, Mitra A, Bossi A, Compérat E, Reiter R, Laguna P, Fiard G, Lunelli L, Schade GR, Chiu PKF, Macek P, Kasivisvanathan V, Rosette JJMCH, Polascik TJ, Rastinehad AR, Rodriguez A, Sanchez-Salas R. Refining partial gland ablation for localised prostate cancer: the FALCON project. BJU Int 2025; 135:1000-1009. [PMID: 39905268 DOI: 10.1111/bju.16669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2024] [Revised: 12/20/2024] [Accepted: 01/17/2025] [Indexed: 02/06/2025]
Abstract
OBJECTIVES To provide a contemporary statement on focal therapy (FT) for localised prostate cancer (PCa) from an international and diverse group of physicians treating localised PCa, with the aim of overcoming the limitations of previous consensus statements, which were restricted to early adopters, and to offer direction regarding the various aspects of FT application that are currently not well defined. MATERIALS AND METHODS The FocAL therapy CONsensus (FALCON) project began with a 154-item online survey, developed following a steering committee discussion and literature search. Invitations to participate were extended to a large, diverse group of professionals experienced in PCa management. From 2022 to 2023, a Delphi consensus study consisting of three online rounds was conducted using the Modified Delphi method. A 1-9 Likert scale was used for the survey, which was followed by an in-person expert meeting. The threshold for achieving consensus was set at 70% agreement/disagreement. Six main aspects of FT were covered: (i) patient selection; (ii) energy source selection; (iii) treatment approach; (iv) treatment evaluation and follow-up; (v) treatment cost and accessibility; and (vi) future perspectives. RESULTS Of 246 initial participants, 148 (60%) completed all three rounds. Based on participant feedback, 27 new statements were added in the second round, and 33 questions related to personal expertise, for which consensus was not necessary, were excluded. After the third and final round, consensus had not been reached for 69 items. These items were discussed at the in-person meeting, resulting in a consensus of 57 additional items. Consensus was finally not reached on 12 items. Given the volume of data, the voting outcomes are summarised in this article, with a detailed breakdown presented in the form of figures and tables. CONCLUSIONS The FALCON project delivered a significant consensus on the approach to FT for localised PCa. Additionally, it highlighted gaps in our knowledge that may provide guidance for future research.
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Affiliation(s)
| | - Xavier Cathelineau
- Department of Urology, Institut Mutualiste Montsouris, Paris, France
- Université Paris Cité, Paris, France
| | - Theo M de Reijke
- Department of Urology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Phillip Stricker
- Garvan Institute of Medical Research, Sydney, NSW, Australia
- St Vincent's Clinical School, UNSW Sydney, Sydney, NSW, Australia
- Department of Urology, St. Vincent's Prostate Cancer Centre, Sydney, NSW, Australia
| | - Mark Emberton
- Interventional Oncology, Division of Surgery and Interventional Science, University College London, London, UK
| | - Anna Lantz
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | | | | | | | - Georg Salomon
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Aiman Haider
- Department of Histopathology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Anita Mitra
- Department of Clinical Oncology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Alberto Bossi
- Radiation Oncology Department, Institut Gustave Roussy, Villejuif, France
| | - Eva Compérat
- Department of Pathology, Medical University of Vienna, Vienna, Austria
| | - Robert Reiter
- Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Pilar Laguna
- International School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Gaelle Fiard
- Department of Urology, Grenoble Alpes University Hospital, Université Grenoble Alpes, Grenoble, France
| | - Luca Lunelli
- Department of Urology, Hospital Louis Pasteur, Chartres, France
| | - George R Schade
- Department of Urology, University of Washington School of Medicine, Seattle, WA, USA
| | - Peter Ka-Fung Chiu
- Division of Urology, Department of Surgery, Faculty of Medicine, SH Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Petr Macek
- Department of Urology, Institut Mutualiste Montsouris, Paris, France
- 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | | | - Jean J M C H Rosette
- International School of Medicine, Istanbul Medipol University, Istanbul, Turkey
- Bashkir State Medical University, Ufa, Russia
| | - Thomas J Polascik
- Department of Urological Surgery, Duke University Medical Center, Durham, NC, USA
| | | | - Alejandro Rodriguez
- Department of Urology, Atrium Health Wake Forest Baptist, Winston-Salem, NC, USA
| | - Rafael Sanchez-Salas
- Division of Urology, Department of Surgery, McGill University, Montreal, QC, Canada
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Ng A, Asif A, Kasivisvanathan V. Re: Juan Gómez Rivas, Bhaskar Somani, Moises Rodriguez Socarrás, et al. Shaping the Undergraduate Curriculum in Europe: Consensus Statement from the European School of Urology. Eur Urol. 2022;82:581-83. Eur Urol 2023; 83:e58-e59. [PMID: 36446675 DOI: 10.1016/j.eururo.2022.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 11/10/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Alexander Ng
- Royal Free London NHS Foundation Trust, London, UK; Division of Surgery and Interventional Science, University College London, London, UK; British Urology Researchers in Surgical Training, London, UK.
| | - Aqua Asif
- Division of Surgery and Interventional Science, University College London, London, UK; British Urology Researchers in Surgical Training, London, UK
| | - Veeru Kasivisvanathan
- Division of Surgery and Interventional Science, University College London, London, UK; British Urology Researchers in Surgical Training, London, UK
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Gómez Rivas J, Somani B, Rodriguez Socarrás M, Marra G, Pearce I, Henningsohn L, Zondervan P, Van Poppel H, N'Dow J, Liatsikos E, Palou J. Shaping the Undergraduate Curriculum in Europe: Consensus Statement from the European School of Urology. Eur Urol 2022; 82:581-583. [PMID: 36163308 DOI: 10.1016/j.eururo.2022.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 08/16/2022] [Accepted: 09/02/2022] [Indexed: 11/04/2022]
Abstract
The European School of Urology has created a taskforce to develop a comprehensive, structured urology curriculum with clinical exposure, practical skills, and hands-on training. The curriculum proposal includes cognitive teaching by symptoms and practical aspects to guarantee uniform access to undergraduate medical education in urology among all European countries, regardless of location, local urology exposure, or bias in national curricula.
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Affiliation(s)
- Juan Gómez Rivas
- Department of Urology, Hospital Clínico San Carlos, Madrid, Spain.
| | - Bhaskar Somani
- University Hospital Southampton NHS Trust, Southampton, UK
| | | | - Giancarlo Marra
- Department of Urology, San Giovanni Battista Hospital, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Ian Pearce
- Manchester University NHS Foundation Trust, Manchester, UK
| | - Lars Henningsohn
- Department of Urology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Patricia Zondervan
- Amsterdam University Medical Centers, Department of Urology, Amsterdam, The Netherlands
| | | | - James N'Dow
- Academic Urology Unit, University of Aberdeen, Aberdeen, UK
| | | | - Joan Palou
- Department of Urology, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
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