Dataset Information

Follow-up after focal therapy in renal masses: an international multidisciplinary Delphi consensus project.

ABSTRACT:

Purpose

To establish consensus on follow-up (FU) after focal therapy (FT) in renal masses. To formulate recommendations to aid in clinical practice and research.

Methods

Key topics and questions for consensus were identified from a systematic literature research. A Web-based questionnaire was distributed among participants selected based on their contribution to the literature and/or known expertise. Three rounds according to the Delphi method were performed online. Final discussion was conducted during the "8th International Symposium on Focal Therapy and Imaging in Prostate and Kidney Cancer" among an international multidisciplinary expert panel.

Results

Sixty-two participants completed all three rounds of the online questionnaire. The panel recommended a minimum follow-up of 5 years, preferably extended to 10 years. The first FU was recommended at 3 months, with at least two imaging studies in the first year. Imaging was recommended biannually during the second year and annually thereafter. The panel recommended FU by means of CT scan with slice thickness ?3 mm (at least three phases with excretory phase if suspicion of collecting system involvement) or mpMRI. Annual checkup for pulmonary metastasis by CT thorax was advised. Outside study protocols, biopsy during follow-up should only be performed in case of suspicion of residual/persistent disease or radiological recurrence.

Conclusions

The consensus led to clear FU recommendations after FT of renal masses supported by a multidisciplinary expert panel. In spite of the low level of evidence, these recommendations can guide clinicians and create uniformity in the follow-up practice and for clinical research purposes.

SUBMITTER: Zondervan PJ

PROVIDER: S-EPMC5114314 | biostudies-literature | 2016 Dec

REPOSITORIES: biostudies-literature

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Publications

Follow-up after focal therapy in renal masses: an international multidisciplinary Delphi consensus project.

Zondervan P J PJ Wagstaff P G K PG Desai M M MM de Bruin D M DM Fraga A F AF Hadaschik B A BA Köllermann J J Liehr U B UB Pahernik S A SA Schlemmer H P HP Wendler J J JJ Algaba F F de la Rosette J J M C H JJ Laguna Pes M P MP

World journal of urology 20160422 12

<h4>Purpose</h4>To establish consensus on follow-up (FU) after focal therapy (FT) in renal masses. To formulate recommendations to aid in clinical practice and research.<h4>Methods</h4>Key topics and questions for consensus were identified from a systematic literature research. A Web-based questionnaire was distributed among participants selected based on their contribution to the literature and/or known expertise. Three rounds according to the Delphi method were performed online. Final discussi ...[more]

PMID: 27106492

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Project description:BackgroundThe lack of agreement regarding what constitutes successful treatment for periprosthetic joint infections (PJI) makes it difficult to compare the different strategies of management that are used in clinical practice and in research studies.Questions/purposesThe aims of this study were to create a consensus definition for success after PJI treatment, and to provide a universal, multidimensional framework for reporting of studies regarding PJI treatment.MethodsA two-round basic Delphi method was used to reach a consensus definition. We invited 159 international experts (orthopaedic surgeons, infectious disease specialists, and clinical researchers) from 17 countries to participate; 59 participated in the first round, and 42 participated in the second round. The final definition consisted of all statements that achieved strong agreement (80% or greater of participants considering a criterion relevant for defining success).ResultsThe consensus definition of a successfully treated PJI is: (1) infection eradication, characterized by a healed wound without fistula, drainage, or pain, and no infection recurrence caused by the same organism strain; (2) no subsequent surgical intervention for infection after reimplantation surgery; and (3) no occurrence of PJI-related mortality (by causes such as sepsis, necrotizing fasciitis). The Delphi panel agreed to defining midterm results as those reported 5 or more years after the definitive PJI surgery, and long-term results as those reported 10 or more years after surgery. Although no consensus was reached on the definition of short-term results, 71% of the participants agreed that 2 years after the definitive PJI surgery is acceptable to define it.ConclusionsThis multidimensional definition of success after PJI treatment may be used to report and compare results of treatment of this catastrophic complication.Level of evidenceLevel V, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Dataset Information

Follow-up after focal therapy in renal masses: an international multidisciplinary Delphi consensus project.

Purpose

Methods

Results

Conclusions

Publications

Follow-up after focal therapy in renal masses: an international multidisciplinary Delphi consensus project.

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