Nationale Praktijkrichtlijn voor de aanpak van gelokaliseerde prostaatkanker
Authors: Mambourg Françoise , Jonckheer Pascale , Piérart Julien , Van Brabandt Hans 
Published: January 2025

SCIENTIFIC REPORT 7 -- 1. INTRODUCTION 7 -- 1.1. DEFINITIONS 7 -- 1.2. GUIDELINE SCOPE 8 -- 1.2.1. Stakeholders consultation 8 -- 1.2.2. Results 9 -- 2. METHODOLOGY 9 -- 2.1. GENERAL APPROACH 9 -- 2.2. CLINICAL QUESTIONS 10 -- 2.3. LITERATURE SEARCH 10 -- 2.3.1. Search strategy 10 -- 2.3.2. Quality appraisal 10 -- 2.4. DATA EXTRACTION AND SUMMARY 11 -- 2.5. FORMULATION OF RECOMMENDATIONS 11 -- 3. WATCHFUL WAITING VERSUS ACTIVE SURVEILLANCE 12 -- 3.1. INTRODUCTION 12 -- 3.2. CLINICAL QUESTIONS 13 -- 3.3. SELECTED STUDIES 13 -- 3.3.1. Guidelines 13 -- 3.3.2. Systematic Reviews 13 -- 3.3.3. Randomised controlled trials 14 -- 3.3.4. Unpublished randomised controlled trials 15 -- 3.4. CLINICAL EVIDENCE 16 -- 3.4.1. Mortality 16 -- 3.4.2. Morbidity 17 -- 3.4.3. Quality of life 18 -- 3.5. GUIDELINES RECOMMENDATIONS 18 -- 3.5.1. Patients point of view 18 -- 3.5.2. Evolution of concepts 19 -- 3.5.3. Risk assessment 19 -- 3.5.4. Treatment 19 -- 3.6. DISCUSSION 22 -- 3.7. GDG ASSESSMENT 23 -- 3.8. RECOMMENDATIONS 25 -- 3.8.1. Quality of the biopsy 25 -- 3.8.2. First assessment 25 -- 3.8.3. Information 25 -- 3.8.4. Men with life expectancy < 10 years 25 -- 3.8.5. Low-risk localised prostate cancer 25 -- 3.8.6. Intermediate-risk localised prostate cancer 25 -- 3.8.7. High-risk localised prostate cancer 25 -- 4. DESCRIPTION OF AN ACTIVE SURVEILLANCE MANAGEMENT 26 -- 4.1. INTRODUCTION 26 -- 4.2. CLINICAL QUESTIONS 26 -- 4.3. STUDIES SELECTED 26 -- 4.3.1. First question 26 -- 4.3.2. Second question 26 -- 4.3.3. Third question 28 -- 4.4. DISCUSSION 30 -- 4.5. GDG ASSESSMENT 30 -- 4.6. RECOMMENDATIONS 31 -- 4.6.1. Biopsy one year after the diagnosis 31 -- 4.6.2. Other tests 31 -- 4.6.3. Routine biopsy 31 -- 4.6.4. Life expectancy < 10y 31 -- 4.6.5. Disease reclassification 31 -- APPENDICES. 32 -- APPENDIX 1. DEFINITIONS 32 -- APPENDIX 1.1. PROSTATE CANCER STAGING 32 -- APPENDIX 1.2. GLEASON SCORE 33 -- APPENDIX 1.3. RISK STRATIFICATION 33 -- APPENDIX 2. FIRST STAKEHOLDERS CONSULTATION 34 -- APPENDIX 2.1. WEBSURVEY PROSTATE SHORT LIST STATEMENTS 34 -- APPENDIX 2.2. WEBSURVEY PROSTATE RESULTS 36 -- APPENDIX 3. LITERATURE SEARCH 42 -- APPENDIX 3.1. CLINICAL PRACTICE GUIDELINES 42 -- APPENDIX 3.2. SYSTEMATIC REVIEWS AND PRIMARY STUDIES FOR QUESTION 1 46 -- APPENDIX 3.3. RANDOMISED CONTROL TRIALS FOR QUESTION 3 49 -- APPENDIX 4. QUALITY APPRAISAL 51 -- APPENDIX 4.1. GUIDELINES 51 -- APPENDIX 4.2. SYSTEMATIC REVIEWS 52 -- APPENDIX 4.3. RANDOMISED CONTROLLED TRIALS 53 -- APPENDIX 5. DATA EXTRACTION TABLES 54 -- APPENDIX 5.1. SYSTEMATIC REVIEWS 54 -- APPENDIX 5.2. PRIMARY STUDIES FOR TREATMENT 58 -- APPENDIX 5.3. PUBLICATIONS NOT INCLUDED 62 -- APPENDIX 5.4. GUIDELINES 63 -- APPENDIX 6. GRADE 67 -- APPENDIX 6.1. LEVELS OF EVIDENCE 67 -- APPENDIX 6.2. DOWN- OR UPGRADING THE EVIDENCE 67 -- APPENDIX 6.3. STRENGTH OF RECOMMENDATIONS 67 -- APPENDIX 6.5. GRADE PROFILE 68 -- APPENDIX 7. LIFE EXPECTANCY TABLE IN BELGIUM 71 -- APPENDIX 8. QUALITY CRITERIA FOR PROSTATE BIOPSY 73 -- APPENDIX 9. EXPERTS AND STAKEHOLDERS FINAL REVIEW 74 -- REFERENCES 77