scholarly journals Can active surveillance really reduce the harms of overdiagnosing prostate cancer? A reflection of real life clinical practice in the PRIAS study

2018 ◽  
Vol 17 (2) ◽  
pp. e92-e95 ◽  
Author(s):  
F.J. Drost ◽  
C. Bangma ◽  
Y. Kakehi ◽  
T. Pickles ◽  
A. Rannikko ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Clinical Practice ◽  
Active Surveillance ◽  
Real Life

scholarly journals Can active surveillance really reduce the harms of overdiagnosing prostate cancer? A reflection of real life clinical practice in the PRIAS study

2018 ◽  
Vol 7 (1) ◽  
pp. 98-105 ◽  
Author(s):  
Frank-Jan H. Drost ◽  
◽  
Antti Rannikko ◽  
Riccardo Valdagni ◽  
Tom Pickles ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Clinical Practice ◽  
Active Surveillance ◽  
Real Life

A national survey of radiation oncologists and urologists on active surveillance for low-risk prostate cancer.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 133-133
Author(s):  
Albert Kim ◽  
Robert Abouassaly ◽  
Simon P. Kim
Keyword(s):  
Prostate Cancer ◽  
Clinical Practice ◽  
Active Surveillance ◽  
National Survey ◽  
Treatment Recommendations ◽  
Low Risk ◽  
Primary Therapy ◽  
Patient Age ◽  
Radiation Oncologists ◽  
Patient Âgé

133 Background: Due to the growing concerns about over-diagnosis and overtreatment of localized prostate cancer (PCa), active surveillance (AS) has become an integral part of clinical practice guidelines. However, many men with low-risk PCa still receive primary therapy with surgery or radiation. Little is known about the barriers regarding the use of AS in clinical practice. To address this, we performed a national survey of radiation oncologists and urologists assessing the current attitudes and treatment for patients diagnosed with low-risk PCa. Methods: From January to July of 2017, 915 radiation oncologists and 940 urologists were surveyed about perceptions of AS for low-risk PCa. The survey queried respondents about their opinions and attitudes towards AS and treatment recommendations for a patient having low-risk PCa with clinical factors varying from patient age (55, 65 and 75 years old), PSA (4 and 8 ng per dl), and tumor volume for Gleason 3+3 disease (2, 4 and 6 cores). Pearson chi-square and multivariable logistic regression were used to identify respondent differences in treatment recommendations for low-risk PCa. Results: Overall, the response rate was 37.3% (n = 691) and similar for radiation oncologists and urologists (35.7% vs. 38.7%; p = 0.18). While both radiation oncologists and urologists viewed AS as effective for low-risk PCa (86.5% vs. 92.0%; p = 0.04), radiation oncologists were more likely to respond that AS increases patient anxiety (49.5% vs. 29.5%; p < 0.001). Overall, recommendations varied markedly based on patient age, PSA, number of cores positive for Gleason 3+3 prostate cancer and respondent specialty. For a 55-year-old male patient with a PSA 8 and 6 cores of Gleason 6 PCa, recommendations of AS were low for both radiation oncologists and urologists (4.4 % vs. 5.2%; adjusted OR: 0.6; p = 0.28). For a 75-year-old patient with a PSA 4 and 2 cores of Gleason 6 PCa, radiation oncologists and urologists most often recommended AS (89.6% vs. 83.4%; adjusted OR: 0.5; p = 0.07). Conclusions: While both radiation oncologists and urologists consider AS effective in the clinical management of low-risk PCa, its use varies markedly by patient age, PCa volume, PSA and physician specialty.

scholarly journals Active Surveillance for the Management of Localized Prostate Cancer (Cancer Care Ontario Guideline): American Society of Clinical Oncology Clinical Practice Guideline Endorsement

2016 ◽  
Vol 34 (18) ◽  
pp. 2182-2190 ◽  
Author(s):  
Ronald C. Chen ◽  
R. Bryan Rumble ◽  
D. Andrew Loblaw ◽  
Antonio Finelli ◽  
Behfar Ehdaie ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Clinical Practice ◽  
Clinical Oncology ◽  
Active Surveillance ◽  
Gleason Score ◽  
Cancer Care ◽  
Specific Antigen ◽  
Localized Prostate Cancer ◽  
Risk Category ◽  
American Society

Purpose To endorse Cancer Care Ontario’s guideline on Active Surveillance for the Management of Localized Prostate Cancer. The American Society of Clinical Oncology (ASCO) has a policy and set of procedures for endorsing clinical practice guidelines developed by other professional organizations. Methods The Active Surveillance for the Management of Localized Prostate Cancer guideline was reviewed for developmental rigor by methodologists. The ASCO Endorsement Panel then reviewed the content and the recommendations. Results The ASCO Endorsement Panel determined that the recommendations from the Active Surveillance for the Management of Localized Prostate Cancer guideline, published in May 2015, are clear, thorough, and based upon the most relevant scientific evidence. ASCO endorsed the Active Surveillance for the Management of Localized Prostate Cancer guideline with added qualifying statements. The Cancer Care Ontario recommendation regarding 5-alpha reductase inhibitors was not endorsed by the ASCO panel. Recommendations For most patients with low-risk (Gleason score ≤ 6) localized prostate cancer, active surveillance is the recommended disease management strategy. Factors including younger age, prostate cancer volume, patient preference, and ethnicity should be taken into account when making management decisions. Select patients with low-volume, intermediate-risk (Gleason 3 + 4 = 7) prostate cancer may be offered active surveillance. Active surveillance protocols should include prostate-specific antigen testing, digital rectal examinations, and serial prostate biopsies. Ancillary radiologic and genomic tests are investigational but may have a role in patients with discordant clinical and/or pathologic findings. Patients who are reclassified to a higher-risk category (Gleason score ≥ 7) or who have significant increases in tumor volume on subsequent biopsies should be offered active therapy.

Active Surveillance for Prostate Cancer in a Real-life Cohort: Comparing Outcomes for PRIAS-eligible and PRIAS-ineligible Patients

2018 ◽  
Vol 1 (3) ◽  
pp. 231-237 ◽  
Author(s):  
Timo F.W. Soeterik ◽  
Harm H.E van Melick ◽  
Lea M. Dijksman ◽  
Douwe H. Biesma ◽  
J. Alfred Witjes ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Active Surveillance ◽  
Real Life

Effectiveness and tolerability of depot formulations of leuprorelin acetate in real life: Analysis of 932 patients with prostate cancer from Brazil.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e16552-e16552
Author(s):  
Carla Simone Moreira Freitas ◽  
Aleida Nazareth Soares
Keyword(s):  
Prostate Cancer ◽  
Clinical Practice ◽  
Locally Advanced ◽  
Hot Flashes ◽  
Specific Antigen ◽  
Real Life ◽  
Cost Savings ◽  
Leuprorelin Acetate ◽  
Long Acting ◽  
Practice Methods

e16552 Background: Clinical trials have shown that androgen deprivation therapy (ADT) is a mainstay of treatment for locally advanced and metastatic prostate cancer. Real-life studies with broader selection criteria may help inform clinical practice. Methods: We reviewed the medical records of 1890 patients with prostate cancer seen at our institution between 01/07 and 07/18. We analyzed patients treated with long-acting leuprorelin acetate, grouping these patients into three strata according to the administration of ADT every 1, 3 or 6 months. The primary outcome was the prostate specific antigen (PSA) levels at 6 and 12 months after treatment initiation. We used Friedman test to compare the distribution of PSA levels over time within each treatment stratum, considering two-sided P values < 0.05 as statistically significant. Results: We analyzed a total of 932 eligible patients, with a median age of 72 years and a median time since diagnosis of prostate cancer of 8.5 months. ADT was administered every 1, 3 and 6 months in 115, 637, and 180 patients, respectively. Nearly half of the patients had locally advanced disease. The table presents PSA levels in each stratum at the three time points. Sexual impotence and hot flashes were the most frequently reported toxicities. Conclusions: Our study confirms that serum PSA levels can be effectively reduced, with a favorable toxicity profile, in most patients treated with long-acting leuprorelin acetate. Administration every 6 months may bring the added benefit of convenience and cost savings in clinical practice.[Table: see text]

Active Surveillance in Low-risk Prostate Cancer – a reality in real life populations?

2018 ◽  
Vol 17 (14) ◽  
pp. e2824
Author(s):  
S. Ramos ◽  
J. Varregoso ◽  
F. Carrasquinho Gomes ◽  
A. Barcelos
Keyword(s):  
Prostate Cancer ◽  
Active Surveillance ◽  
Real Life ◽  
Low Risk ◽  
Risk Prostate Cancer ◽  
Low Risk Prostate Cancer
Sign in / Sign up

Export Citation Format

Share Document