In-depth Analysis of the 2019 Advanced Prostate Cancer Consensus Conference: The Importance of Representation of Medical Specialty and Geographic Regions

Abstract Rapid innovations for treatment and diagnostic procedures in advanced prostate cancer have led to improved outcomes, although uncertainty remains regarding the best management approach in many clinical situations. The 2019 Advanced Prostate Cancer Consensus Conference (APCCC) addressed these areas of uncertainty with a multidisciplinary international expert panel. A total of 57 experts voted on 123 carefully prepared questions. Primary analysis for APCCC 2019 showed consensus (≥75% agreement on one answer) for 33 questions. Here we investigate whether agreement with the consensus answers differed according to medical discipline and region of practice. Overall there was no compelling evidence for group differences in agreement with the consensus answers: expert subgroups differed no more than could be expected by chance due to differences between individual experts. All questions for which consensus was achieved had at least 50% agreement in each expert subgroup. Furthermore, the set of consensus questions changed only moderately if one of the subgroups was excluded from the panel. The identification of consensus questions and answers at APCCC 2019 appeared to be robust to the composition of the panel and well supported. Patient summary The Advanced Prostate Cancer Consensus Conference (APCCC) addresses areas of uncertainty with a multidisciplinary panel of experts. We analyzed the decisions of these panelists and grouped them by their medical discipline and their region of practice. For all questions for which consensus (agreement ≥75%) was found, at least 50% of each group agreed, indicating widespread support of these answer choices. This finding strengthens the consensus achieved at APCCC 2019 and provides further guidance for clinicians.