The 2026 Advanced Prostate Cancer Consensus Conference put 134 questions on high-risk localised, locally advanced and biochemically recurrent prostate cancer to 133 international experts, defining consensus in advance as at least 75% agreement.
Consensus was reached on 44 questions (32.8%), and strong consensus (90% or more) on only seven. The questions covered PSA persistence and recurrence after local treatment and the management of side effects. The voting is expert opinion, not a literature review or meta-analysis.
For clinicians, the main message is the size of the grey zone. Where the panel did not agree, there is room for reasonable variation, and patients should hear that the evidence is uncertain. The detailed results are useful as a reference when a multidisciplinary team faces one of these questions.
- Recognise that most management questions in high-risk and recurrent prostate cancer lack consensus
- Use the APCCC results as a reference point, not a substitute for guidelines
- Discuss uncertainty openly with patients when evidence is thin
- Consider trial enrolment for decisions where experts disagree
Why it matters
It shows how much everyday decision-making in this area rests on opinion rather than trials.
Don't overread it
Expert voting, not a guideline; it does not replace evidence-based recommendations.
The statistics, in plain English
Consensus here means at least three in four experts chose the same answer. Agreement is not evidence — a strong consensus can still be wrong if the underlying data are weak.
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