The accumulation of data through a prospective, multi-center coordinated registry network (CRN) is a practical way to gather real world evidence on the performance of novel prostate ablation technologies. Urologic oncologists, targeted biopsy experts, industry representatives, and the Food and Drug Administration (FDA) convened to discuss the role, feasibility, and important data elements of a CRN to assess new and existing prostate ablation technologies.
A multi-round Delphi consensus approach was performed which included the opinion of 15 expert urologists, representatives of the FDA and leadership from HIFU device manufacturers. Stakeholders provided input in three consecutive rounds, with conference calls following each round to obtain consensus on remaining items. Participants agreed that these elements initially developed for HIFU are compatible with other prostate ablation technologies. CRN elements were reviewed and supplemented with data elements from FDA's common study metrics.
The working group reached consensus on capturing specific patient demographics, treatment details, oncologic outcomes, functional outcomes, and complications. Validated health-related quality of life questionnaires were selected to capture patient-reported outcomes, which include IIEF-5, IPSS, EPIC-26, and MSHQ-EjD. Group consensus was to obtain a follow up multi-parametric MRI and prostate biopsy at approximately 12 months after ablation, with additional imaging or biopsy performed as clinically indicated.
A national prostate ablation CRN brings forth vital practice pattern and outcomes data for this emerging treatment paradigm in the United States. Our multi-stakeholder consensus identifies critical elements to evaluate new and existing energy modalities and devices.