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Abstract：
OBJECTIVE: Prostate cancer care in the Middle East is highly variable and access to specialist multidisciplinary management is limited. Academic tertiary referral centers offer cutting-edge diagnosis and treatment; however, in many parts of the region, patients are managed by non-specialists with limited resources. Due to many factors including lack of awareness and lack of prostate-specific antigen (PSA) screening, a high percentage of men present with locally advanced and metastatic prostate cancer at diagnosis. The aim of these recommendations is to assist clinicians in managing patients with different levels of access to diagnostic and treatment modalities.
METHODS: The first Advanced Prostate Cancer Consensus Conference (APCCC) satellite meeting for the Middle East was held in Beirut, Lebanon, November 2017. During this meeting a consortium of urologists, medical oncologists, radiation oncologist and imaging specialists practicing in Lebanon, Syria, Iraq, Kuwait and Saudi Arabia voted on a selection of consensus questions. An additional workshop to formulate resource-stratified consensus recommendations was held in March 2019.
RESULTS: Variations in practice based on available resources have been proposed to form resource-stratified recommendations for imaging at diagnosis, initial management of localized prostate cancer requiring therapy, treatment of castration-sensitive/naïve advanced prostate cancer and treatment of castration-resistant prostate cancer.
CONCLUSIONS: This is the first regional consensus on prostate cancer management from the Middle East. The following recommendations will be useful to urologists and oncologists practicing in all areas with limited access to specialist multi-disciplinary teams, diagnostic modalities and treatment resources.
METHODS: The first Advanced Prostate Cancer Consensus Conference (APCCC) satellite meeting for the Middle East was held in Beirut, Lebanon, November 2017. During this meeting a consortium of urologists, medical oncologists, radiation oncologist and imaging specialists practicing in Lebanon, Syria, Iraq, Kuwait and Saudi Arabia voted on a selection of consensus questions. An additional workshop to formulate resource-stratified consensus recommendations was held in March 2019.
RESULTS: Variations in practice based on available resources have been proposed to form resource-stratified recommendations for imaging at diagnosis, initial management of localized prostate cancer requiring therapy, treatment of castration-sensitive/naïve advanced prostate cancer and treatment of castration-resistant prostate cancer.
CONCLUSIONS: This is the first regional consensus on prostate cancer management from the Middle East. The following recommendations will be useful to urologists and oncologists practicing in all areas with limited access to specialist multi-disciplinary teams, diagnostic modalities and treatment resources.
摘要：
目的：中东的前列腺癌治疗是高度可变的，获得专科多学科管理的机会有限。学术三级转诊中心提供尖端的诊断和治疗;然而，在该地区的许多地方，患者由资源有限的非专业人员管理。由于许多因素，包括缺乏认识和缺乏前列腺特异性抗原（PSA）筛查，高比例的男性在诊断时出现局部晚期和转移性前列腺癌。这些建议的目的是帮助临床医生管理具有不同诊断和治疗方式的患者。
方法：第一届中东晚期前列腺癌共识会议（APCCC）卫星会议在贝鲁特举行，黎巴嫩,2017年11月。在这次会议上，一个泌尿科医师联盟，医学肿瘤学家,在黎巴嫩执业的放射肿瘤学家和成像专家，叙利亚,伊拉克,科威特和沙特阿拉伯就一些协商一致的问题进行了表决。2019年3月举行了另一次研讨会，以制定资源分层的共识建议。
结果：已提出基于可用资源的实践变化，以形成诊断时成像的资源分层建议，需要治疗的局部前列腺癌的初始管理，去势敏感/初治晚期前列腺癌的治疗和去势抵抗前列腺癌的治疗。
结论：这是中东地区关于前列腺癌治疗的第一个区域共识。以下建议将是有用的泌尿科医师和肿瘤科医师在所有领域的实践有限的专家多学科团队，诊断方式和治疗资源。
方法：第一届中东晚期前列腺癌共识会议（APCCC）卫星会议在贝鲁特举行，黎巴嫩,2017年11月。在这次会议上，一个泌尿科医师联盟，医学肿瘤学家,在黎巴嫩执业的放射肿瘤学家和成像专家，叙利亚,伊拉克,科威特和沙特阿拉伯就一些协商一致的问题进行了表决。2019年3月举行了另一次研讨会，以制定资源分层的共识建议。
结果：已提出基于可用资源的实践变化，以形成诊断时成像的资源分层建议，需要治疗的局部前列腺癌的初始管理，去势敏感/初治晚期前列腺癌的治疗和去势抵抗前列腺癌的治疗。
结论：这是中东地区关于前列腺癌治疗的第一个区域共识。以下建议将是有用的泌尿科医师和肿瘤科医师在所有领域的实践有限的专家多学科团队，诊断方式和治疗资源。
