For over a decade the Advanced Prostate Cancer Consensus Conference (APCCC) covers a variety of topics that greatly impact daily practice. In 2025, a dedicated event was organised to discuss key questions in clinical management of patients with prostate cancer (PC) related to diagnostic tools (APCCC Diagnostics). Here we present the voting results of the APCCC Diagnostics questions. OBJECTIVE; DESIGN, SETTING, AND PARTECIPANTS: APCCC Diagnostics 2025 is a pilot project. The scientific committee for APCCC Diagnostics 2025 developed 88 multiple-choice consensus questions on six different topics. Prior to the conference, the panel members (''panellists'') voted on these questions via a web-based survey. Consensus was defined as ≥75% agreement, with strong consensus defined as ≥90% agreement.
Consensus was only reached on 17 of 88 questions (19%), of which six (7%) received a strong consensus. Specifically, consensus was reached for two of 17 questions (14%) in "how to diagnose PC"; seven of 16 (44%) in "how to stage PC"; three of 14 (21%) in "Biochemical Recurrence Scenario"; two of 11 (18%) in "metastatic disease: what to do?"; zero of 18 (0%) in "monitoring metastatic PC"; and three of 12 (25%) in "radioligand therapy and imaging."
The voting results and their discussion may assist physicians in navigating controversial areas of clinical management related to diagnosis, staging, and restaging in the different clinical settings for PC, particularly where high-level evidence is scarce or conflicting. The findings can also help funders and policymakers in prioritising areas for future research.
European urology. 2026 Jul 03 [Epub ahead of print]
Stefano Fanti, Fabio Turco, Bertrand Tombal, Jochen Walz, Michael S Hofman, Boris Hadaschik, Louise Emmett, Derya Tilki, Giovanna Pecoraro, Giuseppe Salfi, Gerhardt Attard, Himisha Beltran, Anders Bjartell, Alberto Briganti, Irene A Burger, Elena Castro, Juliano J Cerci, Arturo Chiti, Matthew Cooperberg, Karim Fizazi, Nicola Fossati, Andrei Gafita, Andrea Gallina, Karolien Goffin, Lisa G Horvath, Jonas Hugosson, Andrei Iagaru, Nicholas D James, Veeru Kasivisvanathan, Dow-Mu Koh, Glen Kristiansen, Rakesh Kumar, Frederic Lecouvet, Stacy Loeb, Rana R McKay, Michael J Morris, Declan G Murphy, Vedang Murthy, Natacha Naoun, Daniela E Oprea-Lager, Piet Ost, Joe O'Sullivan, Anwar R Padhani, Ganesh Palapattu, Gaetano Paone, Giuseppe Petralia, Monique J Roobol, Oliver A Sartor, Mike Sathekge, David M Schuster, Tyler M Seibert, Daniel E Spratt, Clare Tempany, Nina Tunariu, H Alberto Vargas, Ursula M Vogl, Alexander W Wyatt, Thomas Zilli, Hui-Ming Lin, Aurelius Omlin, Silke Gillessen, Ken Herrmann
Department of Nuclear Medicine, IRCCS AOU Bologna, Bologna, Italy., Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland. Electronic address: ., Division of Urology, Clinique Universitaire St. Luc, Brussels, Belgium., Department of Urology, Institut Paoli-Calmettes Cancer Center, Marseille, France., Prostate Cancer Theranostics and Imaging Centre of Excellence, Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia., Department of Urology, University of Duisburg-Essen, Essen, Germany; German Cancer Consortium, University Hospital Essen, Essen, Germany., Department of Theranostics and Nuclear Medicine, St. Vincent's Hospital, Sydney, Australia; Faculty of Medicine, UNSW Sydney, Sydney, Australia., Martini-Klinik Prostate Cancer Center, University Hospital Hamburg Eppendorf, Hamburg, Germany; Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, Koc University Hospital, Istanbul, Türkiye., Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland; Institute of Oncology Research (IOR), Bellinzona, Switzerland; Clinical and Translational Oncology, Scuola Superiore Meridionale, Napoli, Italy., Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland; Institute of Oncology Research (IOR), Bellinzona, Switzerland., UCL Cancer Institute, University College London, London, UK., Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Harvard Medical School, Boston, MA, USA., Department of Urology, Skåne University Hospital, Malmö, Sweden., Unit of Urology/Division of Oncology, Urological Research Institute, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy., Department of Nuclear Medicine, Kantonsspital Baden, Affiliated Hospital for Research and Teaching of the Faculty of Medicine of the University of Zurich, Baden, Switzerland., Department of Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, Spain., Hospital Nossa Senhora das Graças, Curitiba, Brazil., Nuclear Medicine Department, IRCCS San Raffaele Hospital, Milan, Italy; Faculty of Medicine, Vita-Salute San Raffaele University, Milan, Italy., Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA; Department of Urology, University of California San Francisco, San Francisco, CA, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA., Department of Cancer Medicine, Centre Oscar Lambret, Institut Gustave Roussy, University of Paris Saclay, Villejuif, France., Department of Surgery (Urology Service), Ente Ospedaliero Cantonale, Università della Svizzera Italiana Lugano, Switzerland., Ahmanson Translational Theranostics, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, University of California, Los Angeles, CA, USA., Department of Nuclear Medicine, UZ Leuven, Division of Nuclear Medicine and Molecular Imaging, KU Leuven, Leuven, Belgium., Chris O'Brien Lifehouse, University of Sydney, Sydney, Australia., Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden., Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Stanford University, Stanford, CA, USA., Institute of Cancer Research, London, UK., Centre for Urology Imaging, Prostate, AI and Surgical Studies (COMPASS) Research Group, Division of Surgery and Interventional Science, UCL, London, UK; Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria., Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK., Institute of Pathology, Bonn, Germany., Department of Nuclear Medicine, All India Institute of Medical Sciences, India., Department of Radiology and Medical Imaging, Cliniques Universitaires Saint Luc, Institut de Recherche Expérimentale et Clinique (IREC), Institut du Cancer Roi Albert II (IRA2), Université Catholique de Louvain (UCLouvain), Brussels, Belgium., Department of Urology and Population Health, New York University Langone Health, New York, NY, USA; Department of Surgery/Urology, Manhattan Veterans Affairs, New York, NY, USA., University of California San Diego, La Jolla, CA, USA., Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne Australia; Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia., Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India., Department of Medical Oncology, Gustave Roussy, Paris Saclay University, Villejuif, France., Department of Medical Imaging, Radboud University Medical Center, Nijmegen, the Netherlands., Department of Radiation Oncology, Iridium Network, Antwerp, Belgium; Department of Human Structure and Repair, Ghent University, Ghent, Belgium., Patrick G. Johnston Centre for Cancer Research, Queen's University, Belfast, UK., Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, UK., Department of Urology, University of Michigan, Ann Arbor, MI, USA; Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA., Faculty of Biosciences, Università della Svizzera Italiana, Lugano, Switzerland; Clinic of Nuclear Medicine and Molecular Imaging, Istituto di Diagnostica Integrata della Svizzera Italiana (IDISI), EOC, Bellinzona, Switzerland., Division of Radiology, IEO European Institute of Oncology, IRCCS, Milan, Italy; Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy., Department of Urology, Erasmus University Medical Center, Cancer Institute, Rotterdam, the Netherlands., Department of Medical Oncology, Mayo Clinic Comprehensive Cancer Center, Rochester, MN, USA., Steve Biko Academic Hospital, Pretoria, South Africa; University of Pretoria, Pretoria, South Africa., Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA., Departments of Radiation Medicine and Applied Sciences, Urology, Radiology, and Bioengineering, University of California San Diego School of Medicine, La Jolla, CA, USA., Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Cleveland, OH, USA., Department of Radiology, Massachusetts General Hospital, Boston, MA, USA., Drug Development Unit, The Institute of Cancer Research and The Royal Marsden Hospital NHS Foundation Trust, London, UK., New York University, New York, NY, USA., Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland., Department of Urologic Sciences, Vancouver Prostate Centre, University of British Columbia, Vancouver, BC, Canada; Department of Basic and Translational Research, BC Cancer, Vancouver, BC, Canada., Department of Radiation Oncology, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland; Faculty of Biosciences, Università della Svizzera Italiana, Lugano, Switzerland., Onkozentrum Zurich, University of Zurich and Tumorzentrum Hirslanden Zurich, Zurich, Switzerland., Department of Medical Oncology, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland; Faculty of Biosciences, Università della Svizzera Italiana Lugano, Switzerland., Department of Nuclear Medicine, University of Duisburg-Essen, Essen, Germany; German Cancer Consortium, University Hospital Essen, Essen, Germany.