Clinical Characterization of Patients Diagnosed with Prostate Cancer and Undergoing Conservative Management: A PIONEER Analysis Based on Big Data

被引：11

作者：

Gandaglia, Giorgio ^{[1
,2
,3
]}

Pellegrino, Francesco ^{[2
,3
]}

Golozar, Asieh ^{[4
,5
]}

De Meulder, Bertrand ^{[6
]}

Abbott, Thomas ^{[7
]}

Achtman, Ariel ^{[8
]}

Omar, Muhammad Imran ^{[1
,9
]}

Alshammari, Thamir ^{[10
]}

Areia, Carlos ^{[11
]}

Asiimwe, Alex ^{[12
]}

Beyer, Katharina ^{[13
]}

Bjartell, Anders ^{[14
]}

Campi, Riccardo ^{[1
,15
,16
]}

Cornford, Philip ^{[17
]}

Falconer, Thomas ^{[18
]}

Feng, Qi ^{[7
]}

Gong, Mengchun ^{[19
,20
]}

Herrera, Ronald ^{[12
]}

Hughes, Nigel ^{[21
]}

Hulsen, Tim ^{[22
]}

Kinnaird, Adam ^{[23
]}

Lai, Lana Y. H. ^{[24
]}

Maresca, Gianluca ^{[25
]}

Mottet, Nicolas ^{[1
]}

Oja, Marek ^{[26
,27
]}

Prinsen, Peter ^{[28
]}

Reich, Christian ^{[29
]}

Remmers, Sebastiaan ^{[30
]}

Roobol, Monique J. ^{[30
]}

Sakalis, Vasileios ^{[31
]}

Seager, Sarah ^{[32
]}

Smith, Emma J. ^{[1
]}

Snijder, Robert ^{[7
]}

Steinbeisser, Carl ^{[12
]}

Thurin, Nicolas H. ^{[33
]}

Hijazy, Ayman ^{[6
]}

van Bochove, Kees ^{[34
]}

van den Bergh, Roderick C. N. ^{[35
]}

Van Hemelrijck, Mieke ^{[13
]}

Willemse, Peter-Paul ^{[1
,36
]}

Williams, Andrew E. ^{[37
]}

Kermani, Nazanin Zounemat ^{[38
]}

Evans-Axelsson, Susan ^{[12
]}

Briganti, Alberto ^{[1
,2
,3
]}

N'Dow, James ^{[1
,9
]}

机构：

[1] European Assoc Urol, Guidelines Off, Arnhem, Netherlands

[2] IRCCS San Raffaele Hosp, Urol Res Inst, Dept Urol, Milan, Italy

[3] IRCCS San Raffaele Hosp, Urol Res Inst, Div Expt Oncol, Milan, Italy

[4] Odysseus Data Serv, New York, NY USA

[5] Northeastern Univ, OHDSI Ctr, Boston, MA USA

[6] Assoc EISBM, Vourles, France

[7] Astellas Pharma Inc, Northbrook, IL USA

[8] Movember Fdn, Melbourne, Australia

[9] Univ Aberdeen, Acad Urol Unit, Aberdeen, Scotland

[10] Riyadh Elm Univ, Riyadh, Saudi Arabia

[11] Univ Oxford, Oxford, England

[12] Bayer AG, Berlin, Germany

[13] Kings Coll London, Translat Oncol & Urol Res, London, England

[14] Lund Univ, Dept Translat Med, Lund, Sweden

[15] Univ Florence, Careggi Hosp, Unit Urol Robot Surg & Renal Transplantat, Florence, Italy

[16] Univ Florence, Dept Expt & Clin Med, Florence, Italy

[17] Liverpool Univ Hosp, Liverpool, England

[18] Columbia Univ, Dept Biomed Informat, New York, NY USA

[19] Southern Med Univ, Nanfang Hosp, Guangzhou, Peoples R China

[20] DHC Technol, Beijing, Peoples R China

[21] Janssen R&D, Epidemiol, Beerse, Belgium

[22] Philips Res, Dept Hosp Serv & Informat, Eindhoven, Netherlands

[23] Univ Alberta, Edmonton, AB, Canada

[24] Univ Manchester, Manchester, England

[25] NHS Grampian, Dept Urol, Grampian, Scotland

[26] Univ Tartu, Inst Comp Sci, Tartu, Estonia

[27] STACC, Tartu, Estonia

[28] Netherlands Comprehens Canc Org, Eindhoven, Netherlands

[29] IQVIA, London, England

[30] Erasmus Univ, Canc Inst, Med Ctr, Rotterdam, Netherlands

[31] Gen Hosp Thessaloniki Agios Pavlos, Dept Urol, Thessaloniki, Greece

[32] IQVIA, RWS, Durham, NC USA

[33] Univ Bordeaux, INSERM CIC P 1401, Bordeaux PharmacoEpi, Bordeaux, France

[34] The Hyve, Utrecht, Netherlands

[35] St Antonius Hosp, Utrecht, Netherlands

[36] Univ Med Ctr Utrecht, Canc Ctr, Dept Urol, Utrecht, Netherlands

[37] Tufts Med Ctr, Inst Clin Res & Hlth Policy Studies, Boston, MA USA

[38] Imperial Coll London, Data Sci Inst, Dept Comp, London, England

来源：

EUROPEAN UROLOGY | 2024年 / 85卷 / 05期

关键词：

Prostate cancer; Conservative management; Survival; Outcomes; Big data; PIONEER;

D O I：

10.1016/j.eururo.2023.06.012

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Conservative management is an option for prostate cancer (PCa) patients either with the objective of delaying or even avoiding curative therapy, or to wait until palliative treatment is needed. PIONEER, funded by the European Commission Innovative Medicines Initiative, aims at improving PCa care across Europe through the application of big data analytics. Objective: To describe the clinical characteristics and long-term outcomes of PCa patients on conservative management by using an international large network of real- world data. Design, setting, and participants: From an initial cohort of >100 000 000 adult individuals included in eight databases evaluated during a virtual study-a-thon hosted by PIONEER, we identified newly diagnosed PCa cases (n = 527 311). Among those, we selected patients who did not receive curative or palliative treatment within 6 mo from diagnosis (n = 123 146). Outcome measurements and statistical analysis: Patient and disease characteristics were reported. The number of patients who experienced the main study outcomes was quantified for each stratum and the overall cohort. Kaplan-Meier analyses were used to estimate the distribution of time to event data. Results and limitations: The most common comorbidities were hypertension (35-73%), obesity (9.2-54%), and type 2 diabetes (11-28%). The rate of PCa-related symptomatic progression ranged between 2.6% and 6.2%. Hospitalization (12-25%) and emergency department visits (10-14%) were common events during the 1st year of follow-up. The probability of being free from both palliative and curative treatments decreased during follow-up. Limitations include a lack of information on patients and disease characteristics and on treatment intent. Conclusions: Our results allow us to better understand the current landscape of patients with PCa managed with conservative treatment. PIONEER offers a unique opportunity to characterize the baseline features and outcomes of PCa patients managed conservatively using real-world data. Patient summary: Up to 25% of men with prostate cancer (PCa) managed conservatively experienced hospitalization and emergency department visits within the 1st year after diagnosis; 6% experienced PCa-related symptoms. The probability of receiving therapies for PCa decreased according to time elapsed after the diagnosis. (c) 2023 The Author(s). Published by Elsevier B.V. on behalf of European Association of Urology. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

引用

页码：457 / 465

页数：9

共 21 条

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