SIU-ICUD: Localized Prostate Cancer

The International Consultation on Urologic Diseases (ICUD) is now 45 years old, representing an illustrious tradition. Since its inauguration in 1980, the 55 topic-oriented ICUDs have defined the state of the art and served as important, internationally recognized references. They have been widely distributed and relied upon as sources of high-quality information and broadly based perspectives on disease management. A unique aspect of the ICUD is its tradition of international collaboration and discussion. The explicit strategy has been to seek input on disease management from diverse experts from around the world, acknowledging that differences in economics, culture, politics, demographics, and health care delivery influence practice patterns and approaches to clinical problems. In fact, the first ICUD focused on prostate cancer—making the articles in this edition a symbolic completion of a 45-year cycle.

Each of the 55 ICUDs produced to date represents a substantial collegial and collaborative effort. Each consultation involved 50 to 100 individuals serving as editors, chapter (or committee) chairs, and committee members. Over time, the structure of the ICUD has evolved considerably. The initiative began as a voluntary collaboration among international and national urological associations, the World Health Organization (WHO), and the Union for International Cancer Control (UICC). On 28 June 1994, the ICUD was formally established as a scientific, international, non-profit NGO under Belgian law. Its mission was to facilitate collaboration on an “organization to organization” basis with the WHO and the UICC. The aim of the ICUD has been to promote improvements in the management of urological diseases worldwide by producing evidence-based recommendations. This approach involves assembling experts in urology and related fields to develop chapters grounded in the best available evidence. The recommendations are designed to be internationally relevant, recognizing that resources and cultural influences vary significantly across countries. Although the ICUD’s recommendations are not intended as formal guidelines, many of them have historically been incorporated into national guidelines. The ICUD was for led many years by Prof. Saad Khoury (Paris, France) and Prof. Paul Abrams (Bristol, UK). The Société Internationale d’Urologie (SIU) eventually became involved—initially as a collaborating partner and later assuming full responsibility for managing the initiative.

The World Urologic Oncology Federation (WUOF), an independent Federation affiliated with the SIU, serves as the umbrella organization for 20 urologic oncology societies around the world. It was a natural fit as the organizational partner for oncology-related topics. In 2018, the WUOF accepted responsibility for the oncology component of the ICUDs. The first WUOF-sponsored ICUD publication, entitled “Molecular Biomarkers in Urologic Oncology”, was released in November 2020, followed by “Kidney Cancer” in October 2022. The current volume, “Localized Prostate Cancer”, is the third publication under this structure. All three of these comprehensive textbooks are freely available as downloadable PDFs on the WUOF website: www.WUOF.org.

The ICUD process has evolved significantly over time. Historically, groups of experts responsible for specific chapters would meet in person—often multiple times and for several days—to reach consensus and resolve disagreements. While effective, this approach was very resource-intensive and is no longer practical or necessary. The advent of virtual meetings has greatly enhanced the ability to collaborate internationally at minimal cost. This shift has enabled extensive consultation and collaboration among chapter committee members, unconstrained by resource limitations. This has resulted in the high quality of the articles presented in this Issue.

The articles featured in this Issue of SIUJ constitute an up-to-date primer on localized prostate cancer [1,2,3,4,5,6,7,8,9,10]. They include an outstanding summary of the epidemiology of prostate cancer [1], as well as a thorough review of the benefits and risks of screening [2]. Also featured is a well-crafted summary of the evidence supporting prostate cancer prevention strategies, including recommendations for health maintenance and prostate cancer risk reduction [3,4]. An excellent overview of recent developments in imaging for localized prostate cancer is presented [5], along with a comprehensive summary of advances in our understanding of the disease’s molecular genetics [6]. In addition, three articles focus on treatment—including an exploration of the rationale and conceptual basis for focal therapy [7], a detailed description of specific focal treatment techniques [8], and an insightful review of the recent advancements in robotic prostatectomy [9]. The Issue concludes with a review of the management of node-positive disease [10].

This ICUD was edited by three co-editors—Scott Eggener, Mack Roach, and Laurence Klotz—and benefited greatly from the contributions of numerous international experts. Industry sponsorship played a critical role in the success of this initiative, and we are sincerely grateful for their support.

We believe the articles in this ICUD will significantly advance the global understanding of key issues in prostate cancer. In doing so, they will contribute to improved clinical management, better patient outcomes, and enhanced quality of life.