Abstract
BACKGROUND: The Advanced Prostate Cancer Consensus Conference (APCCC) is a forum for discussing and debating current questions regarding the clinical management of patients with advanced prostate cancer, with a particular focus on these controversies. The aim of this study is to summarize and discuss the results of APCCC-JAPAN 2025 and APCCC 2024 to elucidate the current consensus for advanced prostate cancer in Japan. METHODS: A total of 183 topics on advanced prostate cancer with substantial effects on daily practice but insufficient high-level evidence were addressed at APCCC 2024. From these, 16 questions were selected and presented by a panel of six prostate cancer experts at APCCC-JAPAN 2025 during the 112(th) Annual Meeting of the Japanese Urological Association. Japanese urologists attending the symposium cast their votes on questions on their smartphones using a web-based tool. The results were compared with those obtained at APCCC 2024. RESULTS: Differences in voting results were observed between APCCC-JAPAN 2025 and APCCC 2024, particularly regarding treatment strategies for localized high-risk prostate cancer and metastatic hormone-sensitive prostate cancer. CONCLUSIONS: The APCCC-JAPAN 2025 highlighted critical aspects of the current issues surrounding the management of advanced prostate cancer in Japan. Both similarities and differences were observed in the treatment approaches employed by Japanese urologists and global prostate cancer experts.