Increasing Rate of Noninterventional Treatment Management in Localized Prostate Cancer Candidates for Active Surveillance: A North American Population-Based Study

被引：9

作者：

Bandini, Marco ^{[1
,2
,3
]}

Nazzani, Sebastiano ^{[2
,3
,4
]}

Marchioni, Michele ^{[2
,3
,5
]}

Preisser, Felix ^{[2
,3
,6
]}

Tian, Zhe ^{[2
,3
]}

Moschini, Marco ^{[1
]}

Abdollah, Firas ^{[7
,8
]}

Suardi, Nazareno ^{[1
]}

Graefen, Markus ^{[6
]}

Montorsi, Francesco ^{[1
]}

Shariat, Shahrokh F. ^{[9
]}

Saad, Fred ^{[2
,3
]}

Briganti, Alberto ^{[2
,3
]}

Karakiewicz, Pierre, I ^{[2
,3
]}

机构：

[1] Univ Vita Salute San Raffaele, IRCCS Osped San Raffaele, URI, Unit Urol,Div Oncol, Milan, Italy

[2] CR CHUM, Montreal, PQ, Canada

[3] Inst Canc Montreal, Montreal, PQ, Canada

[4] Univ Milan, IRCCS Policlin San Donato, Acad Dept Urol, Milan, Italy

[5] Univ G dAnnunzio, SS Annunziata Hosp, Dept Urol, Chieti, Italy

[6] Univ Med Ctr Hamburg Eppendorf, Martini Klin, Hamburg, Germany

[7] Henry Ford Hlth Syst, Henry Ford Hosp, Vartikuti Urol Inst, Detroit, MI USA

[8] Henry Ford Hlth Syst, Henry Ford Hosp, VUI Ctr Outcomes Res Analyt & Evaluat VCORE, Detroit, MI USA

[9] Med Univ Vienna, Dept Urol, Vienna, Austria

来源：

CLINICAL GENITOURINARY CANCER | 2019年 / 17卷 / 01期

关键词：

Active surveillance; Local treatment; Non-interventional treatment; Prostate cancer; SEER registries; ANDROGEN-DEPRIVATION THERAPY; MORTALITY; TRENDS;

D O I：

10.1016/j.clgc.2018.09.011

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

We quantified the 2010-2014 rate of noninterventional treatment (NIT) management in active surveillance (AS) candidates according to 16 Surveillance, Epidemiology, and End Results (SEER) registries. The rate of NIT was markedly increased across all examined SEER registries within the study period. Nonetheless, important differences distinguish those who received high-end NIT from low-end NIT. Background: The rate of noninterventional treatment (NIT) in prostate cancer (PCa) active surveillance (AS) candidates is on the rise. However, contemporary data are unavailable. We described community-based NIT rates within 16 Surveillance Epidemiology and End Results (SEER) registries between 2010 and 2014. Patients and Methods: We identified 23,360 PCa patients who fulfilled the University of California San Francisco AS criteria (prostate-specific antigen [PSA] < 10 ng/mL, clinical T stage <= T2a, Gleason score <= 6, and positive cores < 33%). Annual NIT rates as well as patient distribution according to PSA, age, number of positive cores, and clinical T stage were studied. Multivariable logistic regression analysis tested NIT predictors. Results: Between 2010 and 2014, the NIT rate increased from 30.2% to 57.5% (P = .004). Within 16 SEER registries, NIT rates ranged from 25.9% to 62%. NIT rate increased uniformly within all examined registries. Of patient and tumor characteristics (PSA > 4 ng/mL, cT2a and > 1 positive core) only the proportion of NIT patients aged < 65 years increased over time from 47.3% to 53.2% (P = .03). By multivariable logistic regression analysis predicting NIT rate, older age (odd ratio [OR] = 1.05), more contemporary year of diagnosis (OR = 1.41), and being unmarried (OR = 1.45) and uninsured (OR = 2.41) were independent predictors. Conclusion: The NIT rate has markedly increased across all examined SEER registries. Nonetheless, important differences distinguish those who received high-end NIT from low-end NIT. PCa characteristics of NIT patients remained unchanged over time. However, in addition to geographical differences in NIT rates, patient characteristics such as age, marital status, and insurance status represent potential NIT access barriers. (C) 2018 Elsevier Inc. All rights reserved.

引用

页码：72 / +

页数：11

共 21 条

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