Discrepancies Between Global Consensus and Local Implementation in the Management of Advanced Prostate Cancer

The biennial Advanced Prostate Cancer Consensus Conference (APCCC) provides expert-based recommendations on clinical topics for which high-level evidence is lacking. These consensus statements reflect the views of a worldwide panel of more than 100 specialists. There may be discrepancies in local implementation because of context-specific factors. To explore this for the Dutch situation, a national multidisciplinary panel of 34 specialists used a stepwise approach to evaluate selected APCCC 2024 questions. After individual voting, results were discussed in a plenary meeting with partial revoting. Discordance with APCCC consensus was observed for 35% of the questions. Items with the greatest disagreement were revisited in an online follow-up meeting. National deviations were largely regarded justified because of several contextual factors, including wider clinical adoption of prostate-specific membrane antigen positron emission tomography/computed tomography in the Netherlands. Our approach may provide an adequate means of identifying barriers for local compliance with the international consensus recommendations. Patient summary: International experts established consensus statements on the treatment of advanced prostate cancer for topics with unclear evidence. Dutch specialists reviewed these recommendations to determine which ones fit best with local care.