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Fosså SD, Holck Storås A, Aas K, Børge Johannesen T, Maria Gjelsvik Y, Myklebust TÅ. Pretreatment Patient-reported Overall Health: A Prognostic Factor for Early Overall Mortality After Primary Curative Treatment of Prostate Cancer. EUR UROL SUPPL 2024; 63:62-70. [PMID: 38558766 PMCID: PMC10979064 DOI: 10.1016/j.euros.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2024] [Indexed: 04/04/2024] Open
Abstract
Background and objective Registry-based studies for prostate cancer (PCa) document higher overall mortality (OM) after high-dose radiotherapy (RT) than after radical prostatectomy (RP). Our aim was to explore the association between pretreatment patient-reported health ("OverallHealth": OH) and curative treatment type, and the impact on early OM. Methods New PCa patients registered between 2017 and 2019 in the Cancer Registry of Norway (n = 1949) completed the European Organisation for Research and Treatment of Cancer Quality-of-Life Core 30 (QLQ-C30) questionnaire before RP (n = 592) or RT (n = 610) or after allocation to active surveillance (AS; n = 747). We dichotomised the QLQ-C30 summary score to classify patients with un-impaired versus impaired OH. Standard univariable and multivariable analyses with treatment type or OM as the outcome were conducted. The mean observation time was 4.7 years (standard deviation 1.0). Statistical significance was set at p < 0.05. Key findings and limitations Impaired OH was more frequent in the RT group (38%) than in the RP (25%) or AS (28%) group (p < 0.001). Higher age, higher risk group, and impaired OH increased the probability of undergoinRT rather than RP (p < 0.001). Impaired OH was associated with a twofold higher early OM rate in the RT group (16% vs 8%; p = 0.009) and fourfold higher OM rate in the AS group (13% vs 3%; p < 0.001). These findings remained significant in Cox regression analyses controlled for age and risk group. After RP, only locally advanced high-risk tumours were significantly associated with OM. Unknown psychometrics for the OH variable is the main study limitation. Conclusions and clinical implications Pretreatment patient-reported impaired OH, measured as the QLQ-C30 summary score, was positively associated with allocation to RT or AS and is a prognostic factor for early OM. Before allocation to RT or AS, elderly patients with PCa should be screened and treated for health problems that can be remedied. Future studies should determine the psychometrics of the QLQ-C30 summary score in comparison to established frailty screening instruments. Patient summary Patient-reported scores reflecting their overall health can help in choosing curative treatment for prostate cancer and are associated with survival during the first 5 years after treatment.
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Affiliation(s)
- Sophie D. Fosså
- Department of Oncology, Oslo University Hospital, University of Oslo, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Anne Holck Storås
- Department of Oncology, Oslo University Hospital, University of Oslo, Oslo, Norway
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Kirsti Aas
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Urology, Akershus University Hospital, Lørenskog, Norway
| | | | | | - Tor Å. Myklebust
- Department of Registration, Cancer Registry of Norway, Oslo, Norway
- Department of Research and Innovation, Møre and Romsdal Hospital Trust, Ålesund, Norway
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Tiruye T, O'Callaghan M, Ettridge K, Moretti K, Jay A, Higgs B, Santoro K, Kichenadasse G, Beckmann K. Clinical and functional outcomes for risk-appropriate treatments for prostate cancer. BJUI COMPASS 2024; 5:109-120. [PMID: 38179028 PMCID: PMC10764171 DOI: 10.1002/bco2.288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/14/2023] [Accepted: 08/15/2023] [Indexed: 01/06/2024] Open
Abstract
Objectives To describe real-world clinical and functional outcomes in an Australian cohort of men with localised prostate cancer according to treatment type and risk category. Subjects and methods Men diagnosed from 2008 to 2018 who were enrolled in South Australian Prostate Cancer Clinical Outcomes Collaborative registry-a multi-institutional prospective clinical registry-were studied. The main outcome measures were overall survival, cancer-specific survival, decline in functional outcomes, biochemical recurrence and transition to active treatment following active surveillance. Multivariable adjusted models were applied to estimate outcomes. Results Of the 8513 eligible men, majority of men (46%) underwent radical prostatectomy (RP) followed by external beam radiation therapy with or without androgen deprivation therapy (EBRT +/- ADT) in 22% of the cohort. Five-year overall survival was above 91%, and 5-year prostate cancer-specific survival was above 97% in the low- and intermediate-risk categories across all treatments. Five-year prostate cancer-specific survival in the active surveillance group was 100%. About 37% of men with high-risk disease treated with RP and 17% of men treated with EBRT +/- ADT experienced biochemical recurrence within 5 years of treatment. Of men on active surveillance, 15% of those with low risk and 20% with intermediate risk converted to active treatment within 2 years. The decline in urinary continence and sexual function 12 months after treatment was greatest among men who underwent RP while the decline in bowel function was greatest for men who received EBRT +/- ADT. Conclusion This contemporary real-world evidence on risk-appropriate treatment outcomes helps inform treatment decision-making for clinicians and patients.
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Affiliation(s)
- Tenaw Tiruye
- Cancer Epidemiology and Population Health Research Group, Allied Health and Human PerformanceUniversity of South AustraliaAdelaideAustralia
- Public Health DepartmentDebre Markos UniversityDebre MarkosEthiopia
| | - Michael O'Callaghan
- South Australian Prostate Cancer Clinical Outcomes CollaborativeAdelaideAustralia
- Flinders Health and Medical Research InstituteFlinders UniversityAdelaideAustralia
- Discipline of MedicineUniversity of AdelaideAdelaideAustralia
- Flinders Medical CentreBedford ParkAustralia
| | - Kerry Ettridge
- Health Policy CentreSouth Australian Health and Medical Research InstituteAdelaideAustralia
- School of Public HealthUniversity of AdelaideAdelaideAustralia
| | - Kim Moretti
- Cancer Epidemiology and Population Health Research Group, Allied Health and Human PerformanceUniversity of South AustraliaAdelaideAustralia
- South Australian Prostate Cancer Clinical Outcomes CollaborativeAdelaideAustralia
- Discipline of SurgeryUniversity of AdelaideAdelaideAustralia
| | - Alex Jay
- Flinders Medical CentreBedford ParkAustralia
| | - Braden Higgs
- Cancer Epidemiology and Population Health Research Group, Allied Health and Human PerformanceUniversity of South AustraliaAdelaideAustralia
- Department of Radiation OncologyRoyal Adelaide HospitalAdelaideAustralia
| | - Kerry Santoro
- Southern Adelaide Local Health NetworkAdelaideAustralia
| | - Ganessan Kichenadasse
- Flinders Health and Medical Research InstituteFlinders UniversityAdelaideAustralia
- Flinders Medical CentreBedford ParkAustralia
| | - Kerri Beckmann
- Cancer Epidemiology and Population Health Research Group, Allied Health and Human PerformanceUniversity of South AustraliaAdelaideAustralia
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Bryant E, Broomfield C, Burrows J, McLean S, Marks P, Maloney D, Touyz S, Maguire S. Gaining consensus on clinical quality outcomes for eating disorders: Framework for the development of an Australian national minimum dataset. BMJ Open 2023; 13:e071150. [PMID: 37076147 PMCID: PMC10124290 DOI: 10.1136/bmjopen-2022-071150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/21/2023] Open
Abstract
OBJECTIVES Eating disorders (EDs) are complex psychiatric illnesses requiring multidisciplinary care across both mental and medical healthcare settings. Currently, no nationally comprehensive, consistent, agreed on or mandated data set or data collection strategy exists for EDs in Australia: thus, little is known about the outcomes of care nor treatment pathways taken by individuals with EDs. InsideOut Institute was contracted by the Australian Government Department of Health to develop a minimum dataset (MDS) for the illness group with consideration given to data capture mechanisms and the scoping of a national registry. DESIGN A four-step modified Delphi methodology was used, including national consultations followed by three rounds of quantitative feedback by an expert panel. SETTING Due to social distancing protocols throughout the global SARS-CoV-2 pandemic, the study was conducted online using video conferencing (Zoom and Microsoft Teams) (Step 1), email communication and the REDCap secure web-based survey platform (Steps 2-4). PARTICIPANTS 14 data management organisations, 5 state and territory government departments of health, 2 Aboriginal and Torres Strait Islander advising organisations and 28 stakeholders representing public and private health sectors across Australia participated in consultations. 123 ED experts (including lived experience) participated in the first quantitative round of the Delphi survey. Retention was high, with 80% of experts continuing to the second round and 73% to the third. MAIN OUTCOME MEASURES Items and categories endorsed by the expert panel (defined a priori as >85% rating an item or category 'very important' or 'imperative'). RESULTS High consensus across dataset items and categories led to the stratification of an identified MDS. Medical status and quality of life were rated the most important outcomes to collect in an MDS. Other items meeting high levels of consensus included anxiety disorders, depression and suicidality; type of treatment being received; body mass index and recent weight change. CONCLUSIONS Understanding presentation to and outcomes from ED treatment is vital to drive improvements in healthcare delivery. A nationally agreed MDS has been defined to facilitate this understanding and support improvements.
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Affiliation(s)
- Emma Bryant
- InsideOut Institute for Eating Disorders, Faculty of Medicine and Health, University of Sydney and Sydney Local Health District, Camperdown, Sydney, Australia
| | - Catherine Broomfield
- InsideOut Institute for Eating Disorders, Faculty of Medicine and Health, University of Sydney and Sydney Local Health District, Camperdown, Sydney, Australia
| | - Jennifer Burrows
- InsideOut Institute for Eating Disorders, Faculty of Medicine and Health, University of Sydney and Sydney Local Health District, Camperdown, Sydney, Australia
| | - Sian McLean
- Department of Psychology, Counselling and Therapy, La Trobe University, Melbourne, Victoria, Australia
- Australia and New Zealand Academy for Eating Disorders, Castlecrag, New South Wales, Australia
| | - Peta Marks
- InsideOut Institute for Eating Disorders, Faculty of Medicine and Health, University of Sydney and Sydney Local Health District, Camperdown, Sydney, Australia
| | - Danielle Maloney
- InsideOut Institute for Eating Disorders, Faculty of Medicine and Health, University of Sydney and Sydney Local Health District, Camperdown, Sydney, Australia
| | - Stephen Touyz
- InsideOut Institute for Eating Disorders, Faculty of Medicine and Health, University of Sydney and Sydney Local Health District, Camperdown, Sydney, Australia
| | - Sarah Maguire
- InsideOut Institute for Eating Disorders, Faculty of Medicine and Health, University of Sydney and Sydney Local Health District, Camperdown, Sydney, Australia
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Variation in patient reported outcomes following radical prostatectomy: A bi-national registry-based study. Urol Oncol 2023; 41:105.e9-105.e18. [PMID: 36437157 DOI: 10.1016/j.urolonc.2022.10.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 09/01/2022] [Accepted: 10/20/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVE Radical prostatectomy (RP) is a common and widely used treatment for localized prostate cancer. Sequela following RP may include urinary incontinence and sexual dysfunction, outcomes which are recorded within a bi-national Prostate Cancer Outcomes Registry. The objective was to report population-wide urinary incontinence and sexual function outcomes recorded at 12 months following RP; and to quantify and explore factors associated with variation in outcome. MATERIALS AND METHODS The Prostate Cancer Outcomes Registry of Australia and New Zealand (PCOR-ANZ) was used for this study. Participants were treated with radical prostatectomy between 2016 and 2020. Domain summary scores for urinary incontinence and sexual function from the EPIC-26 instrument were the main outcomes, taken at 12 months following surgery (6-18 months). "Major" urinary and sexual function bother were also assessed. Variation in outcomes was investigated using linear and logistic multivariable regression models adjusted for covariates: age, socioeconomic status, PSA at diagnosis, surgical technique, surgical specimen grade group, margin status, and clinician surgical volume. RESULTS AND CONCLUSIONS The analytic cohort included 13,083 men with the mean urinary incontinence domain score being 76/100 (SD = 25) with 9.2% reporting major bother. For sexual function, the mean score was 29/100 (SD = 26) with 46% reporting major bother. Of the examined variables, age at surgery and surgical volume category were most predictive of function, with disparities exceeding minimally important differences, though large variation was observed between urologists within volume categories. There is considerable variation in 12-month postprostatectomy functional outcomes. Variation is explained by both patient and clinician factors, though some confounders are unmeasured in this cohort.
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5
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Jung G, Kim JK, Jeon SS, Chung JH, Kwak C, Jeong CW, Ahn H, Joung JY, Kwon TG, Park SW, Byun SS. Establishment of Prospective Registry of Active Surveillance for Prostate Cancer: The Korean Urological Oncology Society Database. World J Mens Health 2023; 41:110-118. [PMID: 35118841 PMCID: PMC9826918 DOI: 10.5534/wjmh.210163] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/25/2021] [Accepted: 10/31/2021] [Indexed: 01/21/2023] Open
Abstract
PURPOSE To establish a prospective registry for the active surveillance (AS) of prostate cancer (PC) using the Korean Urological Oncology Society (KUOS) database and to present interim analysis. MATERIALS AND METHODS The KUOS registry of AS for PC (KUOS-AS-PC) was organized in May 2019 and comprises multiple institutions nationwide. The eligibility criteria were as follows: patients with (1) pathologically proven PC; (2) pre-biopsy prostate-specific antigen (PSA) ≤20 ng/mL; (3) International Society of Urological Pathology (ISUP) grade 1 or 2 (no cribriform pattern 4); (4) clinical T stage ≤T2c; (5) positive core ratio ≤50%; and (6) maximal cancer involvement in the core ≤50%. Detailed longitudinal clinical information, including multi-parametric magnetic resonance imaging and disease-specific outcomes, was recorded. RESULTS From May 2019 to June 2021, 296 patients were enrolled, and 284 were analyzed. The mean±standard deviation (SD) age at enrollment was 68.7±8.2 years. The median follow-up period was 11.2 months (5.9-16.8 mo). Majority of patients had pre-biopsy PSA ≤10 ng/mL (91.2%), PSA density <0.2 ng/mL² (79.7%), ISUP grade group 1 (94.4%), single positive core (65.7%), maximal cancer involvement in the core ≤20% (78.1%), and clinical T stage of T1c or lower (72.9%). Fifty-two (18.3%) discontinued AS for various reasons. Interventions included radical prostatectomy (80.8%), transurethral prostatectomy (5.8%), primary androgen deprivation therapy (5.8%), radiation (5.8%), and focal therapy (1.9%). The mean±SD time to intervention was 8.9±5.2 months. The reasons for discontinuation included pathologic reclassification (59.6%), patient preference (25.0%), and radiologic reclassification (9.6%). Two (4.8%) patients with pathologic Gleason score upgraded to ISUP grade group 4, no biochemical recurrence. CONCLUSIONS The KUOS established a successful prospective database of PC patients undergoing AS in Korea, named the KUOS-AS-PC registry.
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Affiliation(s)
- Gyoohwan Jung
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jung Kwon Kim
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Seong Soo Jeon
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Hoon Chung
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Cheol Kwak
- Department of Urology, Seoul National University Hospital, Seoul National University School of Medicine, Seoul, Korea
| | - Chang Wook Jeong
- Department of Urology, Seoul National University Hospital, Seoul National University School of Medicine, Seoul, Korea
| | - Hanjong Ahn
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae Young Joung
- Department of Urology, Center for Prostate Cancer, National Cancer Center, Goyang, Korea
| | - Tae Gyun Kwon
- Department of Urology, Kyungpook National University Chilgok Hospital, Kyungpook National University School of Medicine, Daegu, Korea
| | - Sung Woo Park
- Department of Urology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Seok-Soo Byun
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Medical Device Development, Seoul National University College of Medicine, Seoul, Korea
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6
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Weng X, Zhong L, Xiang P, Li Y, Paciorek A, Dong L, Broering J, Carroll PR, Sanda M, Wilson L. Cost-effectiveness analysis of primary treatments for localised prostate cancer: A population-based Markov analysis using real-world evidence. Eur J Cancer Care (Engl) 2022; 31:e13740. [PMID: 36239065 DOI: 10.1111/ecc.13740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/14/2022] [Accepted: 09/27/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE We evaluate cost-effectiveness of primary treatments for localised prostate cancer by uniquely combining prospectively collected real-world outcomes and costs from UCSF Cancer of Prostate Strategic Urologic Research Endeavor (CaPSURE™). METHODS Markov models assessed cost-effectiveness of radical prostatectomy (RP), brachytherapy, electron beam radiation therapy (EBRT) and brachytherapy with EBRT by risk from US payers perspective over 8 years. Treatment costs included office visits, hospitalisation, procedures, medication and long-term care. Patients' surveyed HRQoL were mapped into utilities. Incremental cost-effectiveness ratios (ICERs) used cost per quality-adjusted life years (QALYs) and willingness-to-pay of $150,000/QALY. RESULTS Cost-effectiveness analysis (CEA) showed for low-risk prostate cancer, EBRT dominated the lowest cost brachytherapy, but RPns and brachytherapy plus EBRT were cost-effective compared to brachytherapy with ICERs of $18,926 and $41,662 per QALY. In medium-risk patients, RP, EBRT and brachytherapy plus EBRT all were cost-effective compared with brachytherapy, with ICERs of $30,604, $22,588 and $21,627/QALY. In high-risk, brachytherapy dominated all treatments. Procedure cost and utility are driving ICER, but probabilistic sensitivity analysis showed the model was robust across variables. CONCLUSION This first CEA combining prospective real-world evidence for HRQOL outcomes with costs shows cost-effectiveness of treatments vary by risk groups, providing new evidence for treatment decisions.
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Affiliation(s)
- Xiuhua Weng
- Department of Pharmacy, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Lixian Zhong
- College of Pharmacy, Texas A&M University, College Station, Texas, USA
| | - Pin Xiang
- Department of Clinical Pharmacy, School of Pharmacy, The University of California, San Francisco, California, USA
| | - Yiyuan Li
- Department of Pharmacy, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Alan Paciorek
- Helen Diller Family Comprehensive Cancer Center, The University of California, San Francisco, California, USA
| | - Liangliang Dong
- Department of Pharmacy, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Jeanette Broering
- Department of Urology, University of California, San Francisco, California, USA
| | - Peter R Carroll
- Department of Urology, University of California, San Francisco, California, USA
| | - Martin Sanda
- Department of Urology, Emory University, School of Medicine, Atlanta, Georgia, USA
| | - Leslie Wilson
- Department of Clinical Pharmacy, School of Pharmacy, The University of California, San Francisco, California, USA
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7
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Papa N, Bensley JG, Perera M, Evans M, Millar JL. How Prostate Cancer Patients are Surveyed may Influence Self-Reported Sexual Function Responses. J Sex Med 2022; 19:1442-1450. [DOI: 10.1016/j.jsxm.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 06/30/2022] [Accepted: 07/01/2022] [Indexed: 10/16/2022]
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8
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Bajeot AS, Roumiguié M, Rébillard X, Descotes JL, Duguet C, Lebret T, Fournier G, Corbel L, Gamé X, Soulié M. [De novo or secondary metastatic prostate cancer management in France: Observational study from "sentinel multidisciplinary meeting" of the French Association of Urology]. Prog Urol 2022; 32:691-701. [PMID: 35787978 DOI: 10.1016/j.purol.2022.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 04/05/2022] [Accepted: 04/28/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Metastatic prostate cancer (mPCa) is an heterogeneous disease. Metachronous mPCa (MM) seems to have a better prognosis than synchronous mPCa (SM). However, it is difficult to analyze their specificities from national registries. Data from the so-called "sentinel multidisciplinary meeting" (SMDM) would represent a "real life" data collection. The objective of this national pilot study was to evaluate the concept of SMDM through the description and comparison of the diagnosis, management and follow-up of patients with synchronous or metachronous mPCa in 2018. METHODS A survey covering clinical, biological, radiological data as well as treatment initiated and follow-up at 3 and 6 months was sent to the SMDM. All patients diagnosed with metastatic disease (SM or MM) between 01/01/2018 and 11/30/2018 were included. RESULTS In total, 780 patients from 39 centers were included, 408 SM and 372 MM. SM were more symptomatic and had a higher metastatic burden than MM. PET were mostly performed in MM without a prior standard staging. SM patients received more chemotherapy than MM patients whereas new generation androgen deprivation therapy was mostly given to MM patients. At 6 months, there were no more significant difference in clinical presentation between the two groups. CONCLUSION Specificities of SM and MM patients in terms of clinical presentation, metastatic burden and management were described, validating the concept of SMDM as a source of reliable informations. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- A-S Bajeot
- Département d'urologie-andrologie-transplantation rénale, institut universitaire du Cancer, université Paul Sabatier, CHU de Toulouse, Toulouse, France.
| | - M Roumiguié
- Département d'urologie-andrologie-transplantation rénale, institut universitaire du Cancer, université Paul Sabatier, CHU de Toulouse, Toulouse, France
| | | | - J-L Descotes
- Service d'urologie, CHU de Grenoble, Grenoble, France
| | - C Duguet
- Département d'urologie-andrologie-transplantation rénale, institut universitaire du Cancer, université Paul Sabatier, CHU de Toulouse, Toulouse, France
| | - T Lebret
- Service d'urologie, hôpital Foch, Suresnes, France
| | - G Fournier
- Service d'urologie, CHU de Brest, Brest, France
| | - L Corbel
- Service d'urologie, hôpital privé des côtes d'Armor, Plérin, France
| | - X Gamé
- Département d'urologie-andrologie-transplantation rénale, institut universitaire du Cancer, université Paul Sabatier, CHU de Toulouse, Toulouse, France
| | - M Soulié
- Département d'urologie-andrologie-transplantation rénale, institut universitaire du Cancer, université Paul Sabatier, CHU de Toulouse, Toulouse, France
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Rechtman M, Forbes A, Millar JL, Evans M, Dodds L, Murphy DG, Evans SM. Comparison of urinary and sexual patient-reported outcomes between open radical prostatectomy and robot-assisted radical prostatectomy: a propensity score matched, population-based study in Victoria. BMC Urol 2022; 22:18. [PMID: 35130897 PMCID: PMC8822814 DOI: 10.1186/s12894-022-00966-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 01/10/2022] [Indexed: 11/17/2022] Open
Abstract
Background Robot-assisted radical prostatectomy (RARP) rates have been increasing worldwide despite a lack of evidence of superior patient-reported outcomes (PROs) compared to open radical prostatectomy (ORP).
Methods This retrospective study included men who contributed data to the Prostate Cancer Outcomes Registry-Victoria (PCOR-Vic), underwent ORP or RARP between January 2014 and May 2018, and completed the EPIC-26 questionnaire 12 months post-surgery. Urinary and sexual bother items, the urinary incontinence domain score, the urinary irritative/obstructive domain score, the sexual domain score and the pad usage item from the EPIC-26 questionnaire were compared between the two cohorts. Unmatched and propensity score matched cohorts were used to determine if there were differences in urinary and sexual PROs between ORP and RARP after accounting for the patient case-mix and surgeon characteristics. Results Of 3826 patients undergoing radical prostatectomy (RP), 1047 received ORP and 2779 received RARP. Propensity score matching reduced the magnitude of the observed differences in four out of six outcomes (urinary bother, urinary incontinence domain, pad usage and sexual domain). Using a propensity score matched cohort, there were no statistically significant differences for RARP patients, compared to ORP patients, in terms of urinary bother (Rd = 0.47%, P = 0.707), urinary incontinence domain scores (Coeff = − 0.84, P = 0.506), urinary irritative/obstructive domain scores (Coeff = 1.03, P = 0.105), pad usage (Rd = − 0.75%, P = 0.771) and sexual bother (Rd = − 0.89%, P = 0.731). RARP patients had slightly higher sexual domain scores (Coeff = 3.65, P = 0.005). Conclusion There were no differences in urinary PROs between ORP and RARP when assessed 12 months post-surgery. The sexual domain slightly favoured RARP, however this was not deemed clinically significant. Supplementary Information The online version contains supplementary material available at 10.1186/s12894-022-00966-0.
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Affiliation(s)
- Michael Rechtman
- School of Public Health and Preventive Medicine, Monash University, 533 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Andrew Forbes
- School of Public Health and Preventive Medicine, Monash University, 533 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Jeremy L Millar
- School of Public Health and Preventive Medicine, Monash University, 533 St Kilda Road, Melbourne, VIC, 3004, Australia.,Radiation Oncology, Alfred Health, South Block Ground, 55 Commercial Road, Melbourne, VIC, 3004, Australia
| | - Melanie Evans
- School of Public Health and Preventive Medicine, Monash University, 533 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Lachlan Dodds
- Department of Urology, Ballarat Health Services, Ballarat, Australia.,St. John of God Hospital Ballarat, Ballarat, Australia
| | - Declan G Murphy
- Epworth Prostate Centre, Epworth Healthcare, Richmond, VIC, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Sue M Evans
- School of Public Health and Preventive Medicine, Monash University, 533 St Kilda Road, Melbourne, VIC, 3004, Australia. .,Victorian Cancer Registry, 615 St Kilda Rd, Melbourne, VIC, 3004, Australia.
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10
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Bazarbashi S, Su WP, Wong SW, Singarachari RA, Rawal S, Volkova MI, Bastos DA. A Narrative Review of Implementing Precision Oncology in Metastatic Castration-Resistant Prostate Cancer in Emerging Countries. Oncol Ther 2021; 9:311-327. [PMID: 34236692 PMCID: PMC8593077 DOI: 10.1007/s40487-021-00160-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 06/14/2021] [Indexed: 02/08/2023] Open
Abstract
The therapeutic landscape of metastatic castration-resistant prostate cancer (mCRPC) has evolved considerably with the introduction of newer agents, such as poly-ADP ribose polymerase (PARP) inhibitors targeting DNA damage repair mutations. Combining and sequencing novel and existing therapies appropriately is necessary for optimizing the management of mCRPC and ensuring better treatment outcomes. The purpose of this review is to provide evidence-based answers to key clinical questions on treatment selection, treatment sequencing patterns, and factors influencing treatment decisions in the management of mCRPC in the era of PARP inhibitors. This article can also serve as a comprehensive guide to clinicians for optimizing genetic testing and counseling and management of patients with mCRPC. Although the PROfound study has validated the concept of PARP sensitivity across multiple genes associated with homologous recombination repair (HRR) in mCRPC and highlighted the importance of genomic testing in this at-risk patient population, it still remains unclear how patients with rarer HRR mutations will respond to PARP inhibitors. Therefore, real-world data obtained through registry-based randomized controlled trials in the future may help produce robust scientific evidence for supporting optimal clinician decision-making in the management of mCRPC.
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Affiliation(s)
- Shouki Bazarbashi
- Oncology, King Faisal Specialist Hospital and Research Center, Alzahrawi Street, Riyadh, 11211, Saudi Arabia.
| | - Wen-Pin Su
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, No. 35, Rd. Xiao-Tong, Tainan, Taiwan
- Departments of Oncology and Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 35, Rd. Xiao-Tong, Tainan, Taiwan
| | - Siew W Wong
- Medical Oncology, The Cancer Centre, Orchard Road, Singapore, 238859, Singapore
| | - Ramanujam A Singarachari
- Division of Oncology and Hematology, Department of Internal Medicine, Sheikh Khalifa Medical City, Karamah Street, Abu Dhabi, UAE
| | - Sudhir Rawal
- Uro-Oncology, Rajev Gandhi Cancer Institute & Research Centre, Rohini, New Delhi, India
| | - Maria I Volkova
- Oncourology, N.N. Blokhin Cancer Center, Kashirskoye shosse, 24, Moscow, 115478, Russia
| | - Diogo A Bastos
- Oncology, Hospital Sirio-Libanês, 91 Adma Jafet street, São Paulo, Brazil
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11
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Lawrence MG, Porter LH, Clouston D, Murphy DG, Frydenberg M, Taylor RA, Risbridger GP. Knowing what's growing: Why ductal and intraductal prostate cancer matter. Sci Transl Med 2021; 12:12/533/eaaz0152. [PMID: 32132214 DOI: 10.1126/scitranslmed.aaz0152] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 01/16/2020] [Indexed: 12/12/2022]
Abstract
Prostate cancer is a common malignancy, but only some tumors are lethal. Accurately identifying these tumors will improve clinical practice and instruct research. Aggressive cancers often have distinctive pathologies, including intraductal carcinoma of the prostate (IDC-P) and ductal adenocarcinoma. Here, we review the importance of these pathologies because they are often overlooked, especially in genomics and preclinical testing. Pathology, genomics, and patient-derived models show that IDC-P and ductal adenocarcinoma accompany multiple markers of poor prognosis. Consequently, "knowing what is growing" will help translate preclinical research to pinpoint and treat high-risk prostate cancer in the clinic.
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Affiliation(s)
- Mitchell G Lawrence
- Monash Partners Comprehensive Cancer Consortium, Monash Biomedicine Discovery Institute Cancer Program, Prostate Cancer Research Group, Department of Anatomy and Developmental Biology, Monash University, Clayton, VIC 3800, Australia.,Cancer Research Division, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, VIC 3010, Australia
| | - Laura H Porter
- Monash Partners Comprehensive Cancer Consortium, Monash Biomedicine Discovery Institute Cancer Program, Prostate Cancer Research Group, Department of Anatomy and Developmental Biology, Monash University, Clayton, VIC 3800, Australia
| | | | - Declan G Murphy
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, VIC 3010, Australia.,Division of Cancer Surgery, Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, VIC 3000, Australia.,Epworth HealthCare, Melbourne, VIC 3000, Australia
| | - Mark Frydenberg
- Monash Partners Comprehensive Cancer Consortium, Monash Biomedicine Discovery Institute Cancer Program, Prostate Cancer Research Group, Department of Anatomy and Developmental Biology, Monash University, Clayton, VIC 3800, Australia.,Australian Urology Associates, Melbourne, VIC 3000, Australia.,Department of Urology, Cabrini Health, Malvern, VIC 3144, Australia
| | - Renea A Taylor
- Cancer Research Division, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, VIC 3010, Australia.,Monash Partners Comprehensive Cancer Consortium, Monash Biomedicine Discovery Institute Cancer Program, Prostate Cancer Research Group, Department of Physiology, Monash University, Clayton, VIC 3800, Australia
| | - Gail P Risbridger
- Monash Partners Comprehensive Cancer Consortium, Monash Biomedicine Discovery Institute Cancer Program, Prostate Cancer Research Group, Department of Anatomy and Developmental Biology, Monash University, Clayton, VIC 3800, Australia. .,Cancer Research Division, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, VIC 3010, Australia
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12
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Stattin P. A new Editorial Team for the Scandinavian Journal of Urology. Scand J Urol 2021; 55:89. [PMID: 33879039 DOI: 10.1080/21681805.2021.1901412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Pär Stattin
- Editor-In-Chief, Scandinavian Journal of Urology, Professor, Consultant Urology, Department of Surgical Sciences, Uppsala University
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13
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Christiansen O, Benth JŠ, Kirkevold Ø, Bratt O, Slaaen M. Construct Validity of the Questionnaire Quality From the Patients Perspective Adapted for Surgical Prostate Cancer Patients. J Patient Exp 2021; 8:2374373521998844. [PMID: 34179405 PMCID: PMC8205336 DOI: 10.1177/2374373521998844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Patient-reported experience measures (PREMs) are important to capture the patients’ voice. No such measure is routinely used for evaluation after robotic-assisted radical prostatectomy for prostate cancer. The aim of this study was to adapt the short version of the PREM questionnaire quality from the patients’ perspective (QPP), and assess the construct validity of this version. Quality from the patients’ perspective assesses 4 dimensions of quality of care. Involving discussion with user representatives, the QPP short version was adapted by adding 7 context-specific questions based on items from the Expanded Prostate Cancer Index Composite for Clinical Practice. This short version was answered on smartphone or tablet by 265 patients. We used exploratory factor analysis to assess dimensionality. For comparison with previous publications of the QPP, the analysis was repeated after mean imputation of missing values. The factor analysis identified 7 factors among the 30 analyzed items included in the analysis, explaining 64.9% of the variance. After imputation of missing, 2 factors explained 48.6% of the variance. None of these analysis captured the 4 dimensions of the QPP.
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Affiliation(s)
- Ola Christiansen
- The Research Centre for Age Related Functional Decline and Diseases, Innlandet Hospital Trust, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Jūratė Šaltytė Benth
- The Research Centre for Age Related Functional Decline and Diseases, Innlandet Hospital Trust, Norway.,Health Services Research Unit, Akershus University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway
| | - Øyvind Kirkevold
- The Research Centre for Age Related Functional Decline and Diseases, Innlandet Hospital Trust, Norway.,Norwegian Advisory Unit on Ageing and Health, Norway.,Faculty of Health, Care and Nursing, NTNU Gjøvik, Norway
| | - Ola Bratt
- Departement of Urology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Marit Slaaen
- The Research Centre for Age Related Functional Decline and Diseases, Innlandet Hospital Trust, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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14
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The Value of Real-World Data in Understanding Prostate Cancer Risk and Improving Clinical Care: Examples from Swedish Registries. Cancers (Basel) 2021; 13:cancers13040875. [PMID: 33669624 PMCID: PMC7923148 DOI: 10.3390/cancers13040875] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 02/12/2021] [Accepted: 02/16/2021] [Indexed: 01/04/2023] Open
Abstract
Simple Summary Real-world data (RWD), i.e., data reflecting normal clinical practice collected outside the constraints of randomised controlled trials, provide important insights into our understanding of prostate cancer and its management. Clinical cancer registries are an important source of RWD. Depending on their scope and the potential linkage to other data sources, registry-based data can be utilised to address a variety of questions including risk factors, healthcare utilisation, treatment effectiveness, adverse effects, disparities in healthcare access, quality of care and healthcare economics. This review describes the various registry-based RWD sources for prostate cancer research in Sweden (namely the National Prostate Cancer Register, the Prostate Cancer data Base Sweden (PCBaSe) and the Patient-overview Prostate Cancer) and documents their utility for better understanding prostate cancer aetiology and improving clinical care. Abstract Real-world data (RWD), that is, data from sources other than controlled clinical trials, play an increasingly important role in medical research. The development of quality clinical registers, increasing access to administrative data sources, growing computing power and data linkage capacities have contributed to greater availability of RWD. Evidence derived from RWD increases our understanding of prostate cancer (PCa) aetiology, natural history and effective management. While randomised controlled trials offer the best level of evidence for establishing the efficacy of medical interventions and making causal inferences, studies using RWD offer complementary evidence about the effectiveness, long-term outcomes and safety of interventions in real-world settings. RWD provide the only means of addressing questions about risk factors and exposures that cannot be “controlled”, or when assessing rare outcomes. This review provides examples of the value of RWD for generating evidence about PCa, focusing on studies using data from a quality clinical register, namely the National Prostate Cancer Register (NPCR) Sweden, with longitudinal data on advanced PCa in Patient-overview Prostate Cancer (PPC) and data linkages to other sources in Prostate Cancer data Base Sweden (PCBaSe).
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15
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Taylor JM, Chen VE, Miller RC, Greenberger BA. The Impact of Prostate Cancer Treatment on Quality of Life: A Narrative Review with a Focus on Randomized Data. Res Rep Urol 2020; 12:533-546. [PMID: 33150144 PMCID: PMC7605665 DOI: 10.2147/rru.s243088] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 10/06/2020] [Indexed: 01/03/2023] Open
Abstract
Despite excellent oncologic outcomes, the management of localized prostate cancer remains complex and is dependent on multiple factors, including patient life expectancy, medical comorbidities, tumor characteristics, and genetic risk factors. Decades of iterative clinical trials have improved the optimization and utilization of surgical and radiation-based modalities, as well as their combinatorial use with anti-androgen and systemic therapies. While cure rates are high and converging on equivalent disease control should an upfront surgical or radiotherapeutic approach be optimized, the long-term side effects of surgical and radiation-based treatments can differ significantly in nature. Decisions regarding the selection of therapy are therefore best made in an informed and shared medical decision-making process between clinician and patient with respect to cancer control as well as adverse effects. We outline in this narrative review an understanding regarding implications of surgical and radiation treatment on quality of life after treatment, and how these data may be considered in the context of advising patients regarding the selection of therapy. This narrative review largely focuses on the quality of life data obtained from prospective randomized trials of men treated for prostate cancer. We believe this provides the best assessment of the quality of life and can be used to inform patients when making treatment decisions.
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Affiliation(s)
- James M Taylor
- Department of Radiation Oncology, Sidney Kimmel Medical College & Cancer Center at Thomas Jefferson University, Philadelphia, PA, USA
| | - Victor E Chen
- Department of Radiation Oncology, Sidney Kimmel Medical College & Cancer Center at Thomas Jefferson University, Philadelphia, PA, USA
| | - Ryan C Miller
- Department of Radiation Oncology, Sidney Kimmel Medical College & Cancer Center at Thomas Jefferson University, Philadelphia, PA, USA
| | - Benjamin A Greenberger
- Department of Radiation Oncology, Sidney Kimmel Medical College & Cancer Center at Thomas Jefferson University, Philadelphia, PA, USA
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16
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Definitive radiotherapy for prostate cancer in Norway 2006-2015: Temporal trends, performance and survival. Radiother Oncol 2020; 155:33-41. [PMID: 33096165 DOI: 10.1016/j.radonc.2020.10.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 10/14/2020] [Accepted: 10/15/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND More studies are needed to document nation-wide use and effectiveness of curative definitive radiotherapy (Def-RT) in the treatment of prostate cancer (PCa). PATIENTS AND METHODS For 38,960 men diagnosed with PCa without distant metastases from 2006 to 2015 data from the Norwegian Prostate Cancer Registry and a national radiotherapy database (NoRadBase) was analyzed. Overall survival and PCa-specific mortality were described comparing EQD-2 < 74 Gy ("low-dose") with EQD-2 ≥ 74 Gy ("escalated dose"). RESULTS Use of Def-RT decreased (27-24%) whereas the proportion of radical prostatectomies (RPs) increased (31-38%). In high-risk patients the use of RP doubled (18-36%), while the proportion of Def-RT remained stable (about 35%). Before 2010, almost a quarter of patients received low-dose Def-RT with gradual increase of escalated Def-RT thereafter. Escalated Def-RT was associated with significantly more favorable 10-year PCa-specific mortality (4.4% [95% CI: 2.7-10.7%]) than observed after low-dose Def- RT (8.8% [95% CI: 6.2-9.8%), with the most beneficial effects in high-risk patients. Our analyses indicated the need to expand the NoRadBase by consensus-based quality measures. CONCLUSION In this nationwide cohort, the overall use of Def-RT decreased slightly. In high-risk patients the provision of Def-RT remained stable and was accompanied by doubling of patients with RP and reduction of a "no curative treatment" strategy. Escalated dose Def-RT significantly reduced 10-year PCa-specific mortality compared to low-dose Def-RT. Aiming for cancer care equity national radiotherapy registries for PCa should regularly monitor data based on consensus-based quality measures enabling feedback to the responsible hospitals.
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17
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Lawson KA, Daignault K, Abouassaly R, Khanna A, Martin L, Goldenberg M, Hamilton RJ, Loblaw A, Warde P, Saarela O, Finelli A. Hospital-level Effects Contribute to Variations in Prostate Cancer Quality of Care. Eur Urol Oncol 2020; 4:494-497. [PMID: 32938571 DOI: 10.1016/j.euo.2020.08.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 08/21/2020] [Indexed: 12/01/2022]
Abstract
A paucity of real-world data exists highlighting whether variations in prostate cancer quality of care occur at a hospital level, independent of differences in case mix. To overcome this knowledge gap, we benchmarked hospital-level quality (n = 1245 hospitals) across a broad multidisciplinary panel of previously reported disease-specific, expert-defined quality indicators (QIs), adjusting for differences in patient case mix by indirect standardization. A composite measure of prostate cancer quality-the prostate cancer quality score (PC-QS)-was derived, and associations between PC-QS and hospital volume, academic status, and location as well as patient all-cause mortality were determined. After adjusting for the case mix, of the total of 1245 hospitals evaluated, 2-37% were identified as those performing significantly below the national average for a given QI. Hospitals with a higher PC-QS displayed larger patient volumes, were more commonly academic affiliated, and had lower overall mortality. Collectively, our data-driven benchmarking analysis reveals that widespread hospital-level variations exist in prostate cancer quality of care after adjusting for differences in case mix, with the PC-QS serving as a novel, validated, quality benchmarking tool. PATIENT SUMMARY: Our statistical benchmarking method shows that the quality of prostate cancer care varies between hospitals, after accounting for differences in patient characteristics. The prostate cancer quality score is a novel, validated, quality benchmarking tool.
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Affiliation(s)
- Keith A Lawson
- Division of Urology, Department of Surgical Oncology, Princess Margaret Cancer Centre-University Health Network, Toronto, ON, Canada; Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Katherine Daignault
- Department of Statistical Sciences, University of Toronto, Toronto, ON, Canada
| | - Robert Abouassaly
- Division of Urology, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA; Glickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Abhinav Khanna
- Division of Urology, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA; Glickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Lisa Martin
- Division of Urology, Department of Surgical Oncology, Princess Margaret Cancer Centre-University Health Network, Toronto, ON, Canada
| | - Mitchell Goldenberg
- Division of Urology, Department of Surgical Oncology, Princess Margaret Cancer Centre-University Health Network, Toronto, ON, Canada; Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Robert J Hamilton
- Division of Urology, Department of Surgical Oncology, Princess Margaret Cancer Centre-University Health Network, Toronto, ON, Canada; Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Andrew Loblaw
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada
| | - Padraig Warde
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Olli Saarela
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
| | - Antonio Finelli
- Division of Urology, Department of Surgical Oncology, Princess Margaret Cancer Centre-University Health Network, Toronto, ON, Canada; Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada.
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18
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Malik Z, Di Lorenzo G, Pichler A, De Giorgi U, Hitier S, Ecstein-Fraisse E, Ozatilgan A, Carles J. Effect of Baseline Characteristics on Cabazitaxel Treatment Duration in Patients with Metastatic Castration-Resistant Prostate Cancer: A Post Hoc Analysis of the Compassionate Use/Expanded Access Programs and CAPRISTANA Registry. Cancers (Basel) 2020; 12:cancers12040995. [PMID: 32316580 PMCID: PMC7226228 DOI: 10.3390/cancers12040995] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 04/14/2020] [Accepted: 04/15/2020] [Indexed: 02/07/2023] Open
Abstract
We examined factors that may impact cabazitaxel treatment duration in a real-life setting in a compassionate use program, expanded access program, and prospective observational study in metastatic castration-resistant prostate cancer (mCRPC). Patients with mCRPC previously treated with docetaxel (N = 1,621) received cabazitaxel 25 mg/m2 intravenously every 3 weeks until disease progression, death, unacceptable toxicity or physician/patient decision. The median number of cabazitaxel cycles was six (range, 1-49); 708 patients (43.7%) received >6 cycles. Patients receiving >6 cycles tended to have a better Eastern Cooperative Oncology Group performance status of 0-1 (p = 0.0017 for ≤6 vs. >6 cycles). Overall, 348 patients (21.5%) were ≥75 years of age; 139 (39.9%) received >6 cycles. The main reason for discontinuation was disease progression; however, in patients receiving 1-2 cycles, the main reason for discontinuation was adverse events. Only 52 patients (3.2%) progressed during cycles 1-2. Cabazitaxel was well tolerated in these studies, which included some elderly and frail patients, offering clinicians an important treatment option in the management of mCRPC. Proactive management of adverse events may allow patients to receive a higher number of cabazitaxel cycles and derive greater benefit.
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Affiliation(s)
- Zafar Malik
- Clinical Oncology, The Clatterbridge Cancer Centre NHS Foundation Trust, Wirral CH63 4JY, UK
- Correspondence:
| | - Giuseppe Di Lorenzo
- Department of Medicine and Health Sciences ‘Vincenzo Tiberio’, University of Molise, 86100 Campobasso, Italy
- Medical Oncology, Tortora Hospital, 84016 Pagani, Salerno, Italy
| | - Angelika Pichler
- Department of Hematology and Oncology, Regional Hospital Hochsteiermark, 8700 Leoben, Austria
| | - Ugo De Giorgi
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy
| | - Simon Hitier
- Department of Biostatistics, Sanofi, 91380 Chilly-Mazarin, France
| | | | - Ayse Ozatilgan
- Global Medical Affairs Oncology, Sanofi, Cambridge, MA 02142, USA
| | - Joan Carles
- Vall d’Hebron University Hospital, Vall d’Hebron Institute of Oncology, 08035 Barcelona, Spain
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19
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Meregaglia M, Ciani O, Banks H, Salcher-Konrad M, Carney C, Jayawardana S, Williamson P, Fattore G. A scoping review of core outcome sets and their 'mapping' onto real-world data using prostate cancer as a case study. BMC Med Res Methodol 2020; 20:41. [PMID: 32103725 PMCID: PMC7045588 DOI: 10.1186/s12874-020-00928-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 02/17/2020] [Indexed: 12/14/2022] Open
Abstract
Background A Core Outcomes Set (COS) is an agreed minimum set of outcomes that should be reported in all clinical studies related to a specific condition. Using prostate cancer as a case study, we identified, summarized, and critically appraised published COS development studies and assessed the degree of overlap between them and selected real-world data (RWD) sources. Methods We conducted a scoping review of the Core Outcome Measures in Effectiveness Trials (COMET) Initiative database to identify all COS studies developed for prostate cancer. Several characteristics (i.e., study type, methods for consensus, type of participants, outcomes included in COS and corresponding measurement instruments, timing, and sources) were extracted from the studies; outcomes were classified according to a predefined 38-item taxonomy. The study methodology was assessed based on the recent COS-STAndards for Development (COS-STAD) recommendations. A ‘mapping’ exercise was conducted between the COS identified and RWD routinely collected in selected European countries. Results Eleven COS development studies published between 1995 and 2017 were retrieved, of which 8 were classified as ‘COS for clinical trials and clinical research’, 2 as ‘COS for practice’ and 1 as ‘COS patient reported outcomes’. Recommended outcomes were mainly categorized into ‘mortality and survival’ (17%), ‘outcomes related to neoplasm’ (18%), and ‘renal and urinary outcomes’ (13%) with no relevant differences among COS study types. The studies generally fulfilled the criteria for the COS-STAD ‘scope specification’ domain but not the ‘stakeholders involved’ and ‘consensus process’ domains. About 72% overlap existed between COS and linked administrative data sources, with important gaps. Linking with patient registries improved coverage (85%), but was sometimes limited to smaller follow-up patient groups. Conclusions This scoping review identified few COS development studies in prostate cancer, some quite dated and with a growing level of methodological quality over time. This study revealed promising overlap between COS and RWD sources, though with important limitations; linking established, national patient registries to administrative data provide the best means to additionally capture patient-reported and some clinical outcomes over time. Thus, increasing the combination of different data sources and the interoperability of systems to follow larger patient groups in RWD is required.
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Affiliation(s)
| | - Oriana Ciani
- CERGAS, SDA Bocconi, Milan, Italy.,Institute of Health Research, University of Exeter Medical School, Exeter, UK
| | | | | | | | | | - Paula Williamson
- MRC North West Hub for Trials Methodology Research, Department of Biostatistics, University of Liverpool, Liverpool, UK
| | - Giovanni Fattore
- CERGAS, SDA Bocconi, Milan, Italy.,Department of Social and Political Sciences, Bocconi University, Milan, Italy
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20
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Variation in radiotherapy patterns of care in the radical treatment of South Australian men with non-metastatic prostate cancer between 2005-2015. Radiother Oncol 2020; 145:138-145. [PMID: 31978853 DOI: 10.1016/j.radonc.2019.12.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 12/16/2019] [Accepted: 12/22/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND PURPOSE To investigate associations between socio-demographic characteristics and radiotherapy patterns of care in non-metastatic prostate cancer [nmPCa] in South Australia [SA] between 2005-2015 and document practice patterns over time. MATERIALS AND METHODS Men with nmPCa receiving primary curative radiotherapy were identified from SA Prostate Cancer Clinical Outcomes Collaborative database. Adjuvant, salvage and palliative therapies were excluded. Associations between socio-demographic factors (age, residence, socio-economic status, diagnostic period) and radiotherapy mode (external beam radiotherapy [EBRT] vs. brachytherapy [BT]) and technique (low-dose-rate vs. high-dose-rate brachytherapy) were investigated using multivariable logistic regression with separate models for clinical risk categories. RESULTS Of the 1874 men who underwent primary RT, 80% received EBRT and 20% BT. For low and intermediate risk disease, likelihood of receiving EBRT was higher among older men (ORlow = 3.08; 95% CI 1.82-5.22 and ORintermediate = 3.48; 2.28-5.31 for 65-74 yrs vs. <65 yrs) and lower among regional/remote compared with metropolitan residents (ORlow = 0.34; 0.17-0.67 and ORintermediate = 0.57; 0.34-0.94). For intermediate and high risk disease, more recent diagnosis was associated with decreased likelihood of EBRT (ORintermediate = 0.22; 95% CI 0.15-0.33 and ORhigh = 0.50; 0.29-0.88, respectively). Among men receiving BT, low-dose-rate BT use decreased over time for low (OR = 0.19; 0.04-0.89) and intermediate risk disease (OR = 0.32; 0.12-0.84). Dose escalation and intensity modulation for EBRT increased after 2010. CONCLUSION Over the last decade substantial changes in RT for nmPCa were observed. Older age and more remote residence may be barriers to accessing specific types of RT. Further research to understand how these factors affect access is warranted to improve service provision.
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22
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Greenberger BA, Chen VE, Den RB. Combined Modality Therapies for High-Risk Prostate Cancer: Narrative Review of Current Understanding and New Directions. Front Oncol 2019; 9:1273. [PMID: 31850194 PMCID: PMC6896415 DOI: 10.3389/fonc.2019.01273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 11/04/2019] [Indexed: 11/29/2022] Open
Abstract
Despite the many prospective randomized trials that have been available in the past decade regarding the optimization of radiation, hormonal, and surgical therapies for high-risk prostate cancer (PCa), many questions remain. There is currently a lack of level I evidence regarding the relative efficacy of radical prostatectomy (RP) followed by adjuvant radiation compared to radiation therapy (RT) combined with androgen deprivation therapy (ADT) for high-risk PCa. Current retrospective series have also described an improvement in biochemical outcomes and PCa-specific mortality through the use of augmented radiation strategies incorporating brachytherapy. The relative efficacy of modern augmented RT compared to RP is still incompletely understood. We present a narrative review regarding recent advances in understanding regarding comparisons of overall and PCa-specific mortality measures among patients with high-risk PCa treated with either an RP/adjuvant RT or an RT/ADT approach. We give special consideration to recent trends toward the assembly of multi-institutional series targeted at providing high-quality data to minimize the effects of residual confounding. We also provide a narrative review of recent studies examining brachytherapy boost and systemic therapies, as well as an overview of currently planned and ongoing studies that will further elucidate strategies for treatment optimization over the next decade.
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Affiliation(s)
- Benjamin A Greenberger
- Department of Radiation Oncology, Sidney Kimmel Medical College and Cancer Center, Thomas Jefferson University, Philadelphia, PA, United States
| | - Victor E Chen
- Department of Radiation Oncology, Sidney Kimmel Medical College and Cancer Center, Thomas Jefferson University, Philadelphia, PA, United States
| | - Robert B Den
- Department of Radiation Oncology, Sidney Kimmel Medical College and Cancer Center, Thomas Jefferson University, Philadelphia, PA, United States
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23
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Greenberger BA, Zaorsky NG, Den RB. Comparison of Radical Prostatectomy Versus Radiation and Androgen Deprivation Therapy Strategies as Primary Treatment for High-risk Localized Prostate Cancer: A Systematic Review and Meta-analysis. Eur Urol Focus 2019; 6:404-418. [PMID: 31813810 DOI: 10.1016/j.euf.2019.11.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 10/03/2019] [Accepted: 11/03/2019] [Indexed: 11/29/2022]
Abstract
CONTEXT There is little level 1 evidence regarding the relative efficacy of radical prostatectomy (RP) compared with radiotherapy (RT) combined with androgen deprivation therapy (ADT) for high-risk prostate cancer. OBJECTIVE To conduct a systematic review and meta-analysis comparing overall and prostate cancer-specific mortality (OM and PCM) among patients with high-risk prostate cancer treated with RP or RT/ADT. EVIDENCE ACQUISITION We searched PubMed, Scopus, and the Cochrane Library through July 2019 covering a period since 2009. We report the results of our systematic search according to recommendations from the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. Adjusted hazard ratios (aHRs) were extracted for each endpoint. The risk of bias was assessed using the Newcastle-Ottawa Scale. EVIDENCE SYNTHESIS A total of 23 studies with low to moderate risk of bias were found to meet the inclusion criteria. In keeping with prior studies, external beam radiation therapy (XRT) without specification of ADT was associated with worse OM and PCM (aHR 1.65, 95% confidence interval [CI] 1.42-1.91, p < 0.0001: I2 = 53.4%) and (aHR 1.90, 95% CI 1.61-2.23, p < 0.0001: I2 = 50.4%). These associations were weaker although not entirely eliminated when comparing RT/ADT versus RP (PCM aHR 1.54, 95% CI 1.16-2.04, p = 0.002: I2 = 61.5%). Combination of RT and brachytherapy (MaxRT), on the contrary, was associated with improved PCM compared with RP (aHR 0.48, 95% CI 0.30-0.78, p = 0.003: I2 = 23.8%), an effect that was not significant when comparing MaxRT with the combination RP/adjuvant RT (aHR 0.81, 95% CI 0.59-1.11, p = 0.197: I2 = 0%). CONCLUSIONS Evidence demonstrating definitive superiority of either modality is lacking. Recent studies show improved consideration of ADT, radiation dose, brachytherapy boost, and utilization of postoperative adjuvant radiation. Residual confounding continues to limit the interpretation of observational data. PATIENT SUMMARY In the treatment of high-risk prostate cancer, many observational studies reporting higher mortality for radiotherapy demonstrate potential for confounding. More recent studies with current standard of care radiation regimens using androgen deprivation therapy or brachytherapy boost demonstrate approaching equivalence of prostatectomy and radiation modalities. Prospective randomized trials are needed to confirm these findings.
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Affiliation(s)
- Benjamin A Greenberger
- Department of Radiation Oncology, Sidney Kimmel Medical College & Cancer Center at Thomas Jefferson University, Philadelphia, PA, USA.
| | - Nicholas G Zaorsky
- Department of Radiation Oncology, Penn State Cancer Institute, Hershey, PA, USA
| | - Robert B Den
- Department of Radiation Oncology, Sidney Kimmel Medical College & Cancer Center at Thomas Jefferson University, Philadelphia, PA, USA
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Rutzner S, Ganslandt T, Fietkau R, Prokosch HU, Lubgan D. Noncurated Data Lead to Misinterpretation of Treatment Outcomes in Patients With Prostate Cancer After Salvage or Palliative Radiotherapy. JCO Clin Cancer Inform 2019; 3:1-11. [DOI: 10.1200/cci.19.00052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Clinical data warehouses (cDWHs) and cancer registry databases have enabled researchers to conduct clinical analytics with structured electronic health record data. However, these secondary electronic health record sources are often limited in scope because they do not capture the clinical information needed to understand complex clinical questions. Thus, we evaluated the effect of additional curation of data. MATERIALS AND METHODS Clinical data sets of 149 patients with prostate cancer with biochemical recurrence after radical prostatectomy treated with salvage or palliative radiotherapy between 2008 and 2017 from our institutional cDWH and Gießener Tumor Documentation System (GTDS) were linked (data warehouse [DWH] population) for analyzing treatment outcomes. The linked data sets were manually curated (manual postprocessing [MPP], eg, incorporate data from established urologists). The primary outcomes were the impact on data quality of treatment outcomes and the time spent on data curation. RESULTS We obtained significantly more information on disease progression and patient survival (nonsignificant) when using curated data; the biochemical progression-free survival rate at 5 years for the DWH and DWH plus MPP populations was 63% v 30% ( P ≤ .001) and the overall survival rate was 84% v 81% ( P = .479), respectively. The median deviation of completeness and the median concordance of clinical data values were 21.47% (range, 55.38%-100%) and 95.00% (range, 63.40%-100%), respectively. We spent 121 hours, 42 minutes on data curation, with most time required for laboratory values, accounting, for a total of 45 hours, 20 minutes (37.26%). CONCLUSION Our analysis indicates that time-to-event outcomes for patients with prostate cancer cannot be extracted using secondary data sources (cDWH plus GTDS) only. Outcomes data differed between the electronic data (DWH) and the second manual extraction (DWH plus MPP) because of a lack of follow-up data. When using such unique database resources, only baseline characteristics can reliably be extracted.
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Affiliation(s)
- Sandra Rutzner
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Thomas Ganslandt
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Ruprecht-Karls-University Heidelberg, Mannheim, Germany
| | - Rainer Fietkau
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | | | - Dorota Lubgan
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Akaza H, Procopio G, Pripatnanont C, Facchini G, Fava S, Wheatley D, Leung KC, Butt M, Silva A, Castillo L, Karavasilis V, Ӧzatılgan A, Hitier S, Ecstein-Fraisse EB, Ӧzgüroḡlu M. Metastatic Castration-Resistant Prostate Cancer Previously Treated With Docetaxel-Based Chemotherapy: Treatment Patterns From the PROXIMA Prospective Registry. J Glob Oncol 2019; 4:1-12. [PMID: 30260754 PMCID: PMC6223517 DOI: 10.1200/jgo.18.00009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Purpose There is a major clinical need to devise an optimal treatment sequence for the multiple therapy options available for patients with metastatic castration-resistant prostate cancer (mCRPC). In the absence of prospective clinical trials, sequencing information can be derived from large, real-world registry studies. Patients and Methods PROXIMA (Treatment Patterns in Patients With Metastatic Castration-Resistant Prostate Cancer Previously Treated With Docetaxel-Based Chemotherapy) is a large, global, prospective registry study evaluating real-world treatment patterns of patients with mCRPC who experience disease progression during or after docetaxel therapy. Patients were enrolled worldwide between 2011 and 2014. Treatments were determined by the treating physicians and recorded in categories of chemotherapy, hormonal therapy, targeted therapy, immunotherapy, and palliative therapy. Treatment sequencing patterns, response to treatment, and types of progression were recorded and analyzed. Progression-free survival and overall survival with different treatment modalities were analyzed using Kaplan–Meier method. Results Treatment patterns were evaluated in 903 patients. Therapy selection was influenced by region. Hormonal therapy (57.5%) and taxane chemotherapy (26.4%) were the most frequently administered first subsequent treatments after docetaxel. Tumor responses to first subsequent treatment were observed in 22.6% of evaluable patients. Overall survival and progression-free survival did not differ significantly across different treatment modalities. Conclusion Identifying an optimal treatment sequence is vital for improving the care of patients with mCRPC. The PROXIMA registry provided a representative sample of global data on real-world treatment patterns for patients with mCRPC previously treated with docetaxel. These data can be used to devise optimal therapy sequences and inform treatment decisions.
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Affiliation(s)
- Hideyuki Akaza
- Hideyuki Akaza, The University of Tokyo, Tokyo, Japan; Giuseppe Procopio, Istituto Nazionale Tumori; Sergio Fava, Ospedale Civile di Legnano, Milan; Gaetano Facchini, Istituto Nazionale Tumori Istituto di Ricerca e Cura a Carattere Scientifico Fondazione Pascale, Naples, Italy; Choosak Pripatnanont, Prince of Songkla University, Songkla, Thailand; Duncan Wheatley, Royal Cornwall Hospital, Truro; Mohammad Butt, Castle Hill Hospital, Hull, United Kingdom; Kwong Chuen Leung, Queen Elizabeth Hospital, Hong Kong, Special Administrative Region, People's Republic of China; Alberto Silva, Instituto de Cancer do Ceará, Fortaleza, Brazil; Liliana Castillo, Hospital Oncológico Miguel Pérez Carreño, Valencia, Venezuela; Vasilios Karavasilis, Papageorgiou Hospital and Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece; Ayse Ӧzatılgan, Sanofi, Cambridge, MA; Simon Hitier, Sanofi, Chilly-Mazarin; Evelyne B. Ecstein-Fraisse, Sanofi, Paris, France; and Mustafa Ӧzgüroḡlu, Istanbul University, Istanbul, Turkey
| | - Giuseppe Procopio
- Hideyuki Akaza, The University of Tokyo, Tokyo, Japan; Giuseppe Procopio, Istituto Nazionale Tumori; Sergio Fava, Ospedale Civile di Legnano, Milan; Gaetano Facchini, Istituto Nazionale Tumori Istituto di Ricerca e Cura a Carattere Scientifico Fondazione Pascale, Naples, Italy; Choosak Pripatnanont, Prince of Songkla University, Songkla, Thailand; Duncan Wheatley, Royal Cornwall Hospital, Truro; Mohammad Butt, Castle Hill Hospital, Hull, United Kingdom; Kwong Chuen Leung, Queen Elizabeth Hospital, Hong Kong, Special Administrative Region, People's Republic of China; Alberto Silva, Instituto de Cancer do Ceará, Fortaleza, Brazil; Liliana Castillo, Hospital Oncológico Miguel Pérez Carreño, Valencia, Venezuela; Vasilios Karavasilis, Papageorgiou Hospital and Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece; Ayse Ӧzatılgan, Sanofi, Cambridge, MA; Simon Hitier, Sanofi, Chilly-Mazarin; Evelyne B. Ecstein-Fraisse, Sanofi, Paris, France; and Mustafa Ӧzgüroḡlu, Istanbul University, Istanbul, Turkey
| | - Choosak Pripatnanont
- Hideyuki Akaza, The University of Tokyo, Tokyo, Japan; Giuseppe Procopio, Istituto Nazionale Tumori; Sergio Fava, Ospedale Civile di Legnano, Milan; Gaetano Facchini, Istituto Nazionale Tumori Istituto di Ricerca e Cura a Carattere Scientifico Fondazione Pascale, Naples, Italy; Choosak Pripatnanont, Prince of Songkla University, Songkla, Thailand; Duncan Wheatley, Royal Cornwall Hospital, Truro; Mohammad Butt, Castle Hill Hospital, Hull, United Kingdom; Kwong Chuen Leung, Queen Elizabeth Hospital, Hong Kong, Special Administrative Region, People's Republic of China; Alberto Silva, Instituto de Cancer do Ceará, Fortaleza, Brazil; Liliana Castillo, Hospital Oncológico Miguel Pérez Carreño, Valencia, Venezuela; Vasilios Karavasilis, Papageorgiou Hospital and Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece; Ayse Ӧzatılgan, Sanofi, Cambridge, MA; Simon Hitier, Sanofi, Chilly-Mazarin; Evelyne B. Ecstein-Fraisse, Sanofi, Paris, France; and Mustafa Ӧzgüroḡlu, Istanbul University, Istanbul, Turkey
| | - Gaetano Facchini
- Hideyuki Akaza, The University of Tokyo, Tokyo, Japan; Giuseppe Procopio, Istituto Nazionale Tumori; Sergio Fava, Ospedale Civile di Legnano, Milan; Gaetano Facchini, Istituto Nazionale Tumori Istituto di Ricerca e Cura a Carattere Scientifico Fondazione Pascale, Naples, Italy; Choosak Pripatnanont, Prince of Songkla University, Songkla, Thailand; Duncan Wheatley, Royal Cornwall Hospital, Truro; Mohammad Butt, Castle Hill Hospital, Hull, United Kingdom; Kwong Chuen Leung, Queen Elizabeth Hospital, Hong Kong, Special Administrative Region, People's Republic of China; Alberto Silva, Instituto de Cancer do Ceará, Fortaleza, Brazil; Liliana Castillo, Hospital Oncológico Miguel Pérez Carreño, Valencia, Venezuela; Vasilios Karavasilis, Papageorgiou Hospital and Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece; Ayse Ӧzatılgan, Sanofi, Cambridge, MA; Simon Hitier, Sanofi, Chilly-Mazarin; Evelyne B. Ecstein-Fraisse, Sanofi, Paris, France; and Mustafa Ӧzgüroḡlu, Istanbul University, Istanbul, Turkey
| | - Sergio Fava
- Hideyuki Akaza, The University of Tokyo, Tokyo, Japan; Giuseppe Procopio, Istituto Nazionale Tumori; Sergio Fava, Ospedale Civile di Legnano, Milan; Gaetano Facchini, Istituto Nazionale Tumori Istituto di Ricerca e Cura a Carattere Scientifico Fondazione Pascale, Naples, Italy; Choosak Pripatnanont, Prince of Songkla University, Songkla, Thailand; Duncan Wheatley, Royal Cornwall Hospital, Truro; Mohammad Butt, Castle Hill Hospital, Hull, United Kingdom; Kwong Chuen Leung, Queen Elizabeth Hospital, Hong Kong, Special Administrative Region, People's Republic of China; Alberto Silva, Instituto de Cancer do Ceará, Fortaleza, Brazil; Liliana Castillo, Hospital Oncológico Miguel Pérez Carreño, Valencia, Venezuela; Vasilios Karavasilis, Papageorgiou Hospital and Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece; Ayse Ӧzatılgan, Sanofi, Cambridge, MA; Simon Hitier, Sanofi, Chilly-Mazarin; Evelyne B. Ecstein-Fraisse, Sanofi, Paris, France; and Mustafa Ӧzgüroḡlu, Istanbul University, Istanbul, Turkey
| | - Duncan Wheatley
- Hideyuki Akaza, The University of Tokyo, Tokyo, Japan; Giuseppe Procopio, Istituto Nazionale Tumori; Sergio Fava, Ospedale Civile di Legnano, Milan; Gaetano Facchini, Istituto Nazionale Tumori Istituto di Ricerca e Cura a Carattere Scientifico Fondazione Pascale, Naples, Italy; Choosak Pripatnanont, Prince of Songkla University, Songkla, Thailand; Duncan Wheatley, Royal Cornwall Hospital, Truro; Mohammad Butt, Castle Hill Hospital, Hull, United Kingdom; Kwong Chuen Leung, Queen Elizabeth Hospital, Hong Kong, Special Administrative Region, People's Republic of China; Alberto Silva, Instituto de Cancer do Ceará, Fortaleza, Brazil; Liliana Castillo, Hospital Oncológico Miguel Pérez Carreño, Valencia, Venezuela; Vasilios Karavasilis, Papageorgiou Hospital and Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece; Ayse Ӧzatılgan, Sanofi, Cambridge, MA; Simon Hitier, Sanofi, Chilly-Mazarin; Evelyne B. Ecstein-Fraisse, Sanofi, Paris, France; and Mustafa Ӧzgüroḡlu, Istanbul University, Istanbul, Turkey
| | - Kwong Chuen Leung
- Hideyuki Akaza, The University of Tokyo, Tokyo, Japan; Giuseppe Procopio, Istituto Nazionale Tumori; Sergio Fava, Ospedale Civile di Legnano, Milan; Gaetano Facchini, Istituto Nazionale Tumori Istituto di Ricerca e Cura a Carattere Scientifico Fondazione Pascale, Naples, Italy; Choosak Pripatnanont, Prince of Songkla University, Songkla, Thailand; Duncan Wheatley, Royal Cornwall Hospital, Truro; Mohammad Butt, Castle Hill Hospital, Hull, United Kingdom; Kwong Chuen Leung, Queen Elizabeth Hospital, Hong Kong, Special Administrative Region, People's Republic of China; Alberto Silva, Instituto de Cancer do Ceará, Fortaleza, Brazil; Liliana Castillo, Hospital Oncológico Miguel Pérez Carreño, Valencia, Venezuela; Vasilios Karavasilis, Papageorgiou Hospital and Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece; Ayse Ӧzatılgan, Sanofi, Cambridge, MA; Simon Hitier, Sanofi, Chilly-Mazarin; Evelyne B. Ecstein-Fraisse, Sanofi, Paris, France; and Mustafa Ӧzgüroḡlu, Istanbul University, Istanbul, Turkey
| | - Mohammad Butt
- Hideyuki Akaza, The University of Tokyo, Tokyo, Japan; Giuseppe Procopio, Istituto Nazionale Tumori; Sergio Fava, Ospedale Civile di Legnano, Milan; Gaetano Facchini, Istituto Nazionale Tumori Istituto di Ricerca e Cura a Carattere Scientifico Fondazione Pascale, Naples, Italy; Choosak Pripatnanont, Prince of Songkla University, Songkla, Thailand; Duncan Wheatley, Royal Cornwall Hospital, Truro; Mohammad Butt, Castle Hill Hospital, Hull, United Kingdom; Kwong Chuen Leung, Queen Elizabeth Hospital, Hong Kong, Special Administrative Region, People's Republic of China; Alberto Silva, Instituto de Cancer do Ceará, Fortaleza, Brazil; Liliana Castillo, Hospital Oncológico Miguel Pérez Carreño, Valencia, Venezuela; Vasilios Karavasilis, Papageorgiou Hospital and Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece; Ayse Ӧzatılgan, Sanofi, Cambridge, MA; Simon Hitier, Sanofi, Chilly-Mazarin; Evelyne B. Ecstein-Fraisse, Sanofi, Paris, France; and Mustafa Ӧzgüroḡlu, Istanbul University, Istanbul, Turkey
| | - Alberto Silva
- Hideyuki Akaza, The University of Tokyo, Tokyo, Japan; Giuseppe Procopio, Istituto Nazionale Tumori; Sergio Fava, Ospedale Civile di Legnano, Milan; Gaetano Facchini, Istituto Nazionale Tumori Istituto di Ricerca e Cura a Carattere Scientifico Fondazione Pascale, Naples, Italy; Choosak Pripatnanont, Prince of Songkla University, Songkla, Thailand; Duncan Wheatley, Royal Cornwall Hospital, Truro; Mohammad Butt, Castle Hill Hospital, Hull, United Kingdom; Kwong Chuen Leung, Queen Elizabeth Hospital, Hong Kong, Special Administrative Region, People's Republic of China; Alberto Silva, Instituto de Cancer do Ceará, Fortaleza, Brazil; Liliana Castillo, Hospital Oncológico Miguel Pérez Carreño, Valencia, Venezuela; Vasilios Karavasilis, Papageorgiou Hospital and Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece; Ayse Ӧzatılgan, Sanofi, Cambridge, MA; Simon Hitier, Sanofi, Chilly-Mazarin; Evelyne B. Ecstein-Fraisse, Sanofi, Paris, France; and Mustafa Ӧzgüroḡlu, Istanbul University, Istanbul, Turkey
| | - Liliana Castillo
- Hideyuki Akaza, The University of Tokyo, Tokyo, Japan; Giuseppe Procopio, Istituto Nazionale Tumori; Sergio Fava, Ospedale Civile di Legnano, Milan; Gaetano Facchini, Istituto Nazionale Tumori Istituto di Ricerca e Cura a Carattere Scientifico Fondazione Pascale, Naples, Italy; Choosak Pripatnanont, Prince of Songkla University, Songkla, Thailand; Duncan Wheatley, Royal Cornwall Hospital, Truro; Mohammad Butt, Castle Hill Hospital, Hull, United Kingdom; Kwong Chuen Leung, Queen Elizabeth Hospital, Hong Kong, Special Administrative Region, People's Republic of China; Alberto Silva, Instituto de Cancer do Ceará, Fortaleza, Brazil; Liliana Castillo, Hospital Oncológico Miguel Pérez Carreño, Valencia, Venezuela; Vasilios Karavasilis, Papageorgiou Hospital and Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece; Ayse Ӧzatılgan, Sanofi, Cambridge, MA; Simon Hitier, Sanofi, Chilly-Mazarin; Evelyne B. Ecstein-Fraisse, Sanofi, Paris, France; and Mustafa Ӧzgüroḡlu, Istanbul University, Istanbul, Turkey
| | - Vasilios Karavasilis
- Hideyuki Akaza, The University of Tokyo, Tokyo, Japan; Giuseppe Procopio, Istituto Nazionale Tumori; Sergio Fava, Ospedale Civile di Legnano, Milan; Gaetano Facchini, Istituto Nazionale Tumori Istituto di Ricerca e Cura a Carattere Scientifico Fondazione Pascale, Naples, Italy; Choosak Pripatnanont, Prince of Songkla University, Songkla, Thailand; Duncan Wheatley, Royal Cornwall Hospital, Truro; Mohammad Butt, Castle Hill Hospital, Hull, United Kingdom; Kwong Chuen Leung, Queen Elizabeth Hospital, Hong Kong, Special Administrative Region, People's Republic of China; Alberto Silva, Instituto de Cancer do Ceará, Fortaleza, Brazil; Liliana Castillo, Hospital Oncológico Miguel Pérez Carreño, Valencia, Venezuela; Vasilios Karavasilis, Papageorgiou Hospital and Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece; Ayse Ӧzatılgan, Sanofi, Cambridge, MA; Simon Hitier, Sanofi, Chilly-Mazarin; Evelyne B. Ecstein-Fraisse, Sanofi, Paris, France; and Mustafa Ӧzgüroḡlu, Istanbul University, Istanbul, Turkey
| | - Ayse Ӧzatılgan
- Hideyuki Akaza, The University of Tokyo, Tokyo, Japan; Giuseppe Procopio, Istituto Nazionale Tumori; Sergio Fava, Ospedale Civile di Legnano, Milan; Gaetano Facchini, Istituto Nazionale Tumori Istituto di Ricerca e Cura a Carattere Scientifico Fondazione Pascale, Naples, Italy; Choosak Pripatnanont, Prince of Songkla University, Songkla, Thailand; Duncan Wheatley, Royal Cornwall Hospital, Truro; Mohammad Butt, Castle Hill Hospital, Hull, United Kingdom; Kwong Chuen Leung, Queen Elizabeth Hospital, Hong Kong, Special Administrative Region, People's Republic of China; Alberto Silva, Instituto de Cancer do Ceará, Fortaleza, Brazil; Liliana Castillo, Hospital Oncológico Miguel Pérez Carreño, Valencia, Venezuela; Vasilios Karavasilis, Papageorgiou Hospital and Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece; Ayse Ӧzatılgan, Sanofi, Cambridge, MA; Simon Hitier, Sanofi, Chilly-Mazarin; Evelyne B. Ecstein-Fraisse, Sanofi, Paris, France; and Mustafa Ӧzgüroḡlu, Istanbul University, Istanbul, Turkey
| | - Simon Hitier
- Hideyuki Akaza, The University of Tokyo, Tokyo, Japan; Giuseppe Procopio, Istituto Nazionale Tumori; Sergio Fava, Ospedale Civile di Legnano, Milan; Gaetano Facchini, Istituto Nazionale Tumori Istituto di Ricerca e Cura a Carattere Scientifico Fondazione Pascale, Naples, Italy; Choosak Pripatnanont, Prince of Songkla University, Songkla, Thailand; Duncan Wheatley, Royal Cornwall Hospital, Truro; Mohammad Butt, Castle Hill Hospital, Hull, United Kingdom; Kwong Chuen Leung, Queen Elizabeth Hospital, Hong Kong, Special Administrative Region, People's Republic of China; Alberto Silva, Instituto de Cancer do Ceará, Fortaleza, Brazil; Liliana Castillo, Hospital Oncológico Miguel Pérez Carreño, Valencia, Venezuela; Vasilios Karavasilis, Papageorgiou Hospital and Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece; Ayse Ӧzatılgan, Sanofi, Cambridge, MA; Simon Hitier, Sanofi, Chilly-Mazarin; Evelyne B. Ecstein-Fraisse, Sanofi, Paris, France; and Mustafa Ӧzgüroḡlu, Istanbul University, Istanbul, Turkey
| | - Evelyne B Ecstein-Fraisse
- Hideyuki Akaza, The University of Tokyo, Tokyo, Japan; Giuseppe Procopio, Istituto Nazionale Tumori; Sergio Fava, Ospedale Civile di Legnano, Milan; Gaetano Facchini, Istituto Nazionale Tumori Istituto di Ricerca e Cura a Carattere Scientifico Fondazione Pascale, Naples, Italy; Choosak Pripatnanont, Prince of Songkla University, Songkla, Thailand; Duncan Wheatley, Royal Cornwall Hospital, Truro; Mohammad Butt, Castle Hill Hospital, Hull, United Kingdom; Kwong Chuen Leung, Queen Elizabeth Hospital, Hong Kong, Special Administrative Region, People's Republic of China; Alberto Silva, Instituto de Cancer do Ceará, Fortaleza, Brazil; Liliana Castillo, Hospital Oncológico Miguel Pérez Carreño, Valencia, Venezuela; Vasilios Karavasilis, Papageorgiou Hospital and Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece; Ayse Ӧzatılgan, Sanofi, Cambridge, MA; Simon Hitier, Sanofi, Chilly-Mazarin; Evelyne B. Ecstein-Fraisse, Sanofi, Paris, France; and Mustafa Ӧzgüroḡlu, Istanbul University, Istanbul, Turkey
| | - Mustafa Ӧzgüroḡlu
- Hideyuki Akaza, The University of Tokyo, Tokyo, Japan; Giuseppe Procopio, Istituto Nazionale Tumori; Sergio Fava, Ospedale Civile di Legnano, Milan; Gaetano Facchini, Istituto Nazionale Tumori Istituto di Ricerca e Cura a Carattere Scientifico Fondazione Pascale, Naples, Italy; Choosak Pripatnanont, Prince of Songkla University, Songkla, Thailand; Duncan Wheatley, Royal Cornwall Hospital, Truro; Mohammad Butt, Castle Hill Hospital, Hull, United Kingdom; Kwong Chuen Leung, Queen Elizabeth Hospital, Hong Kong, Special Administrative Region, People's Republic of China; Alberto Silva, Instituto de Cancer do Ceará, Fortaleza, Brazil; Liliana Castillo, Hospital Oncológico Miguel Pérez Carreño, Valencia, Venezuela; Vasilios Karavasilis, Papageorgiou Hospital and Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece; Ayse Ӧzatılgan, Sanofi, Cambridge, MA; Simon Hitier, Sanofi, Chilly-Mazarin; Evelyne B. Ecstein-Fraisse, Sanofi, Paris, France; and Mustafa Ӧzgüroḡlu, Istanbul University, Istanbul, Turkey
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Christiansen O, Bratt O, Haug ES, Vaktskjold A, Selnes A, Jordhøy M. TECLA-an innovative technical approach for prostate cancer registries. Scand J Urol 2019; 53:229-234. [PMID: 31264501 DOI: 10.1080/21681805.2019.1634148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: To present a code-driven, electronic database for patients TrEated with robotic-assisted radiCaL prostAtectomy (TECLA), developed at Innlandet Hospital (IH), Trust, Norway, for research, local quality control and to deliver data to the National Cancer Registry of Norway (CRN). Clinical data are directly extracted from the structured documentation in the electronic medical record (EMR).Materials and methods: The urological department at IH treats about 200 patients with robotic-assisted radical prostatectomy (RARP) annually. All consenting patients registered with the procedure code for RARP are included in TECLA. Clinical data are obtained automatically from the EMR, by structured forms. Patient-reported outcome and experience measures (PROMs and PREMs) are filled in by the patients on an iPad or a smartphone.Results: The basic construct of TECLA is presented. From August 2017 to June 2018, 200 men were treated with RARP, of which 182 (91%) provided consent for inclusion in the register. Of these, 97% completed the PROM survey before treatment and 91% at 3 months follow-up. PREMs were completed by 78%. All clinical variables for the hospital stay and for the 6-week follow-up were more than 95% complete.Conclusion: This entirely electronic surgical quality register is easy to use, both for patients and clinicians, and has a high capture rate. The data collection is linked to the clinicians' workflow, without double data entry, so entering data does not add any extra work. The register design can be used by other hospitals for various surgical procedures.
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Affiliation(s)
- Ola Christiansen
- Department of Urology, Innlandet Hospital Trust, Hamar, Norway.,The Research Center for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, Brumunddal, Norway
| | - Ola Bratt
- Department of Urology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | - Arild Vaktskjold
- INN University, Faculty of Social and Health Sciences, Elverum, Norway
| | - Anders Selnes
- Department of Urology, Innlandet Hospital Trust, Hamar, Norway
| | - Marit Jordhøy
- The Research Center for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, Brumunddal, Norway.,Department of Internal Medicine, Innlandet Hospital Trust, Hamar, Norway.,Faculty of Medicine, University in Oslo, Oslo, Norway
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Gandaglia G, Tilki D, Zaffuto E, Fossati N, Pompe RS, Dell’Oglio P, Graefen M, Montorsi F, Briganti A. Are the Results of the Prostate Testing for Cancer and Treatment Trial Applicable to Contemporary Prostate Cancer Patients Treated with Radical Prostatectomy? Results from Two High-volume European Institutions. Eur Urol Focus 2019; 5:545-549. [DOI: 10.1016/j.euf.2017.10.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 09/17/2017] [Accepted: 10/24/2017] [Indexed: 10/18/2022]
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28
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Aning JJ, Reilly GS, Fowler S, Challacombe B, McGrath JS, Sooriakumaran P. Perioperative and oncological outcomes of radical prostatectomy for high-risk prostate cancer in the UK: an analysis of surgeon-reported data. BJU Int 2019; 124:441-448. [DOI: 10.1111/bju.14687] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Jonathan J. Aning
- Bristol Urological Institute; North Bristol NHS Trust; Southmead Hospital; Westbury-on-Trym, Bristol UK
| | - Gavin S. Reilly
- Centre for Statistics in Medicine; Botnar Research Centre; University of Oxford; Oxford UK
| | - Sarah Fowler
- British Association of Urological Surgeons; London UK
| | - Ben Challacombe
- King's Health Partners; Guys Hospital; King's College London; London UK
| | - John S. McGrath
- Exeter Surgical Health Services Research Unit; Royal Devon and Exeter Hospital; Exeter UK
| | - Prasanna Sooriakumaran
- University College London Hospital NHS Foundation Trust; London UK
- Nuffield Department of Surgical Sciences; University of Oxford; Oxford UK
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Jeong CW, Suh J, Yuk HD, Tae BS, Kim M, Keam B, Kim JH, Kim SY, Cho JY, Kim SH, Moon KC, Cheon GJ, Ku JH, Kim HH, Kwak C. Establishment of the Seoul National University Prospectively Enrolled Registry for Genitourinary Cancer (SUPER-GUC): A prospective, multidisciplinary, bio-bank linked cohort and research platform. Investig Clin Urol 2019; 60:235-243. [PMID: 31294132 PMCID: PMC6607078 DOI: 10.4111/icu.2019.60.4.235] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 03/19/2019] [Indexed: 12/24/2022] Open
Abstract
Purpose To establish a prospective, comprehensive, multidisciplinary, bio-bank linked genitourinary cancer cohort based on standard real practice. Materials and Methods We established the Seoul National University Prospectively Enrolled Registry for Genitourinary Cancer (SUPER-GUC), a prospective cohort clinical database and bio-specimen repository system for prostate cancer (SUPER-PC), renal cell carcinoma (SUPER-RCC), and urothelial cancer (SUPER-UC) at a high-volume, tertiary institution. Each cohort consists of several sub-cohorts based on treatment or disease status. Detailed longitudinal clinical information, and general and disease specific patient-reported outcomes are captured. We use the same evaluation format and questionnaires for all participating departments. Patients' blood, urine, tumor, and normal tissues are collected. The number of registered patients and their basic characteristics are summarized. For the surgical sub-cohort, study participation, bio-specimen, and tissue banking rates are analyzed. Results Since March 2016, 11 sub-cohorts for all disease statuses have been opened, ranging from low-risk localized to metastatic disease. SUPER-PC, SUPER-RCC, and SUPER-UC enrolled 929, 796, and 1,221 patients, respectively. Study participation, bio-sampling, and fresh frozen tumor banking rates of surgical sub-cohorts were 89.0% to 93.1%, 91.2% to 99.1%, and 56.9% to 79.1%, respectively. Conclusions SUPER-GUC is a study platform for comparative outcome, quality-of-life, and translational (genetics, biomarkers) research for genitourinary cancer.
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Affiliation(s)
- Chang Wook Jeong
- Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jungyo Suh
- Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hyeong Dong Yuk
- Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.,Department of Urology, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Bum Sik Tae
- Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.,Department of Urology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Miso Kim
- Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Bhumsuk Keam
- Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jin Ho Kim
- Department of Radiation Oncology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Sang Youn Kim
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jeong Yeon Cho
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Seung Hyup Kim
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Kyung Chul Moon
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Gi Jeong Cheon
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Ja Hyeon Ku
- Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hyeon Hoe Kim
- Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Cheol Kwak
- Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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Sampurno F, Kannan A, Lucas M, Liman J, Connor SE, Pearman E, Millar JL, Moore CM, Villanti P, James E, Huland H, Litwin MS, Evans SM. Development of Technologic Solutions to Address Complex Local Requirements of an International Prostate Cancer Clinical Quality Registry. JCO Clin Cancer Inform 2019; 3:1-11. [PMID: 30901234 DOI: 10.1200/cci.18.00114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To detail the process for importing a defined data set into a centralized global registry via a secure file transfer platform and to understand the barriers to the establishment of a centralized global registry. RESULTS A bespoke solution was developed to allow transmission of data from international local data centers to a centralized repository. Data elements included in the import template were drawn from existing International Consortium for Health Outcome Measurement variables and refined to ensure accurate benchmarking as well as feasibility in data completeness. The data set was organized in accordance with the prostate cancer care trajectory. Key considerations in developing the data transfer platform included import file format, process of input validation, and technical provisions. Given the diversity in the legislation and ethical requirements with respect to consent, data handling, and cross-border data transfer across geographic locations, we encouraged each local data center to consult with its legal advisors and research ethics committee early on in the process. DISCUSSION A global collaboration, although highly valuable, posed many challenges because of inconsistent methods of data collection. User acceptance of a system is paramount to the success of establishing a metaregistry. Local information technology support and regular regression testing ensures quality and maintenance of the database. CONCLUSION We developed a Web-based system to facilitate the collection and secure storage of common data, which is scalable and secure. It is anticipated that through systematic recording of data, global standards of clinical practice and outcomes of care will see vast improvements.
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Affiliation(s)
| | | | - Mark Lucas
- Monash University, Melbourne, Victoria, Australia
| | - John Liman
- Monash University, Melbourne, Victoria, Australia
| | | | - Emily Pearman
- University of California, Los Angeles, Los Angeles, CA
| | | | | | - Paul Villanti
- Movember Foundation, East Melbourne, Victoria, Australia
| | - Ellie James
- Movember Foundation, East Melbourne, Victoria, Australia
| | | | - Mark S Litwin
- University of California, Los Angeles, Los Angeles, CA
| | - Sue M Evans
- Monash University, Melbourne, Victoria, Australia
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Hulsen T. An overview of publicly available patient-centered prostate cancer datasets. Transl Androl Urol 2019; 8:S64-S77. [PMID: 31143673 PMCID: PMC6511704 DOI: 10.21037/tau.2019.03.01] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 02/27/2019] [Indexed: 02/05/2023] Open
Abstract
Prostate cancer (PCa) is the second most common cancer in men, and the second leading cause of death from cancer in men. Many studies on PCa have been carried out, each taking much time before the data is collected and ready to be analyzed. However, on the internet there is already a wide range of PCa datasets available, which could be used for data mining, predictive modelling or other purposes, reducing the need to setup new studies to collect data. In the current scientific climate, moving more and more to the analysis of "big data" and large, international, multi-site projects using a modern IT infrastructure, these datasets could be proven extremely valuable. This review presents an overview of publicly available patient-centered PCa datasets, divided into three categories (clinical, genomics and imaging) and an "overall" section to enable researchers to select a suitable dataset for analysis, without having to go through days of work to find the right data. To acquire a list of human PCa databases, scientific literature databases and academic social network sites were searched. We also used the information from other reviews. All databases in the combined list were then checked for public availability. Only databases that were either directly publicly available or available after signing a research data agreement or retrieving a free login were selected for inclusion in this review. Data should be available to commercial parties as well. This paper focuses on patient-centered data, so the genomics data section does not include gene-centered databases or pathway-centered databases. We identified 42 publicly available, patient-centered PCa datasets. Some of these consist of different smaller datasets. Some of them contain combinations of datasets from the three data domains: clinical data, imaging data and genomics data. Only one dataset contains information from all three domains. This review presents all datasets and their characteristics: number of subjects, clinical fields, imaging modalities, expression data, mutation data, biomarker measurements, etc. Despite all the attention that has been given to making this overview of publicly available databases as extensive as possible, it is very likely not complete, and will also be outdated soon. However, this review might help many PCa researchers to find suitable datasets to answer the research question with, without the need to start a new data collection project. In the coming era of big data analysis, overviews like this are becoming more and more useful.
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Affiliation(s)
- Tim Hulsen
- Department of Professional Health Solutions & Services, Philips Research, Eindhoven, The Netherlands
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32
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Tradewell MB, Albersheim J, Dahm P. Use of the IDEAL framework in the urological literature: where are we in 2018? BJU Int 2019; 123:1078-1085. [PMID: 30653798 DOI: 10.1111/bju.14676] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To assess uptake and application of the IDEAL principles in original surgical procedure- or device-related clinical research studies, as well as its reported relevance as characterized by secondary publications, editorials and reviews. MATERIALS AND METHODS IDEAL (Idea, Development, Exploration, Assessment, Long-term study) is a framework that provides stage-specific guidance for surgical innovation and represented a major advance towards raising evidential standards. We performed a comprehensive literature search of all urology-related publications citing one or more of seven key publications on IDEAL in The Lancet and BMJ using multiple databases up to 31 December 2017. RESULTS We identified a total of 150 urology-related manuscripts citing IDEAL, of which 83 (55.3%) were original research and 67 (44.7%) were secondary publications. Among the original research articles, 40 (48.2%) did not explicitly apply IDEAL principles or were not surgical innovation studies. The IDEAL phases of the 43 (51.8%) remaining original research studies were IDEAL, in nine (20.9%), 27 (62.8%), four (9.3%), 0 (0%), and three publications (7.0%), respectively. Across IDEAL stages, 30 (75.0%) studies were prospective, 29 (85.3%) reported ethical oversight, and 39 (90.7%) captured treatment-related harms. None of the studies collected information on physician experience. CONCLUSIONS The IDEAL framework has found widespread adoption in the urology literature as witnessed by a large number of original manuscripts and secondary publications citing IDEAL; however, its application is largely limited to the early stages of surgical innovation, frequently with inappropriate and incomplete implementation. Further efforts are needed to guide investigators in the optimal use of the IDEAL framework as it relates to surgical innovation in urology.
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Affiliation(s)
| | - Jacob Albersheim
- Department of Urology, University of Minnesota, Minneapolis, MN, USA
| | - Philipp Dahm
- Department of Urology, University of Minnesota, Minneapolis, MN, USA.,Urology Section, Minneapolis Veterans Administration Health Care System, Minneapolis, MN, USA
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Cózar JM, Miñana B, Gómez-Veiga F, Rodríguez-Antolín A. Three-year interim results of overall and progression-free survival in a cohort of patients with prostate cancer (GESCAP group). Actas Urol Esp 2019; 43:4-11. [PMID: 29891440 DOI: 10.1016/j.acuro.2018.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 03/13/2018] [Accepted: 03/13/2018] [Indexed: 12/24/2022]
Abstract
AIMS To describe the 3-year progression-free survival (PFS), overall survival (OS) and disease-specific mortality in the prospective prostate cancer GESCAP cohort, as well as the progression to castration resistance in patients on hormone therapy. MATERIAL AND METHODS Prospective, observational, epidemiological, multicentre study. Of the 4087 patients recruited, 3843 were evaluable. The variables analysed were the risk group (localized, locally advanced, lymph involvement, metastatic), age, prostate-specific antigen (PSA) levels, Gleason score and initial treatment. Kaplan Meier survival analysis, the log-rank test and the Cox model were used to evaluate the survival data. RESULTS Three-year PFS was 81.4% and OS was 92.4%. During the 3 years of follow-up, 303 patients died (7.9%), 110 of them (36.3%) due to disease-related causes. The probability of castration resistance for all patients on hormone therapy (n=715) was 14.2%: 5%, 9.9%, 26.1% and 44.4% in localized, locally advanced, lymph involvement and metastatic cancer, respectively (log-rank P<.0001). Patients with metastases had poorer outcomes with respect to PFS, OS, disease-specific mortality and castration resistance. In the multivariate analysis, the Gleason score, PSA and presence of metastases were associated with shorter OS and PFS. CONCLUSIONS Our study showed stratification of risk, with a more unfavourable prognosis for patients with metastases. Patients with locally advanced disease differed with respect to those with localized disease due to their higher risk as regards disease-specific mortality. (Controlled-trials.com ISRCTN19893319).
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Affiliation(s)
- J M Cózar
- Servicio de Urología, Hospital Virgen de las Nieves, Granada, España.
| | - B Miñana
- Servicio de Urología, Hospital Morales Meseguer, Murcia, España
| | - F Gómez-Veiga
- Servicio de Urología, Hospital Universitario de Salamanca-IBSAL-GITUR, Salamanca, España
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Liu Y, Uemura H, Ye D, Lee JY, Chiong E, Pu YS, Razack AHA, Pripatnanont C, Rawal S, Low GKM, Qiu H, Chow WH, Van Kooten Losio M. Prostate cancer in Asia: design of a patient registry to inform real-world treatments, outcomes, and quality of life. Prostate Int 2018; 7:108-113. [PMID: 31485435 PMCID: PMC6713796 DOI: 10.1016/j.prnil.2018.12.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 11/14/2018] [Accepted: 12/08/2018] [Indexed: 11/26/2022] Open
Abstract
Background The incidence of prostate cancer (PC) in Asian countries is increasing for reasons that are not clear. Data describing how PC is diagnosed and treated are fragmented across Asia, with marked intercountry and intracountry differences in outcome and knowledge gaps in clinical diagnostic and treatment practices. To address these knowledge gaps, we have established a PC disease registry with the aim of providing a comprehensive picture of PC diagnosis, prognosis, treatment and outcome, population characteristics, and comorbidities in real-world clinical practice in Asia. Methods This is a multinational, multicenter, longitudinal, and observational registry of PC patients presenting to participating tertiary-care hospitals in eight Asian countries (www.clinicaltrials.gov NCT02546908. Registry Identifier: NOPRODPCR4001). Approximately 3500-4000 eligible patients with existing or newly diagnosed high-risk localized PC (cohort 1), nonmetastatic biochemically recurrent PC (cohort 2), or metastatic PC (cohort 3) will be consecutively enrolled and followed-up for 5 years. An enrollment cap of 600 patients each will be applied to cohorts 1 and 2. Disease status is collected at enrollment, and outcome variables captured at 3-monthly intervals include diagnostic/staging, treatments including reason for change, laboratory results, comorbidities, and concomitant medications. Treatments and survival outcomes will be captured real time until study end. Patient-reported quality-of-life will be measured every 6 months, and medical resource utilization summarized at study end. Data analysis will include exploratory analyses of potential associations between multiple risk factors and socioeconomic variables with disease progression and evaluation of various treatments for PC including novel therapies on clinical outcome and health-related quality-of-life outcomes. Results 3636 men with PC were enrolled until July 2018; 416 in cohort 1, 399 in cohort 2 and 2821 in cohort 3. Discussion A total of 3636 patients were enrolled until July 2018. The prospective disease registry will provide comprehensive and wide-ranging real-world information on how PC is diagnosed and treated in Asia. Such information can be used to inform policy development for best practice and direct clinical study design evaluating new treatments.
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Affiliation(s)
- Yanfang Liu
- Janssen Research and Development, Titusville, NJ 08560, United States
| | - Hirotsugu Uemura
- Department of Urology, Kindai University Hospital, Osaka 589-8511, Japan
| | - Dingwei Ye
- Fudan University Shang Hai Cancer Center, Xuhui District, 200032, China
| | - Ji Y Lee
- The Catholic University of Korea, Seoul St.Mary's Hospital, 06591 Seoul, Korea
| | - Edmund Chiong
- Department of Urology, National University Health System, Singapore
| | - Yeong-S Pu
- Department of Urology, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Azad H A Razack
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, 50603 Malaysia
| | - Choosak Pripatnanont
- Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110 Thailand
| | - Sudhir Rawal
- Rajeev Gandhi Cancer Institutes, 110085, New Delhi, India
| | - Grace K M Low
- Janssen Research and Development, Epidemiology, Ascent, 118222, Singapore
| | - Hong Qiu
- Janssen Research and Development, Titusville, NJ 08560, United States
| | - Weng H Chow
- Janssen Research and Development, Epidemiology, Ascent, 118222, Singapore
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Carles J, Pichler A, Korunkova H, Tomova A, Ghosn M, El Karak F, Makdessi J, Koroleva I, Barnes G, Bury D, Özatilgan A, Hitier S, Katolicka J. An observational, multicentre study of cabazitaxel in patients with metastatic castration-resistant prostate cancer previously treated with docetaxel (CAPRISTANA). BJU Int 2018; 123:456-464. [PMID: 30098093 PMCID: PMC7379594 DOI: 10.1111/bju.14509] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Objectives To obtain routine clinical practice data on cabazitaxel usage patterns for patients with metastatic castration‐resistant prostate cancer (mCRPC) and to describe physician‐assessed cabazitaxel effectiveness, health‐related quality of life (HRQoL) and safety. Patients and Methods CAPRISTANA was an international, observational cohort study examining cabazitaxel use for the treatment of patients with mCRPC. Effectiveness was assessed by overall survival (OS), progression‐free survival (PFS), time to treatment failure (TTF) and disease control rate. HRQoL was assessed using the Functional Assessment of Cancer Therapy‐Prostate questionnaire (FACT‐P) and the three‐level European Quality of Life questionnaire (EQ‐5D‐3L). Safety was assessed by adverse event (AE) reporting. Results A total of 189 patients were treated across 54 centres between April 2012 and June 2016. At baseline, 58.7% had ≥1 comorbidity, 93.7% had an Eastern Cooperative Oncology Group performance status ≤1, and 60.1% had a Gleason score at diagnosis of ≥8. Patients received a median of 6 cabazitaxel cycles; 84.7% received cabazitaxel as second‐line therapy. The median OS, PFS and TTF were 13.2, 5.6 and 4.4 months, respectively. Cabazitaxel led to disease control in 52.9% of patients. HRQoL was maintained (40.3%) or improved (32.2%) in 72.5% of patients based on total FACT‐P scores. Interestingly, 53.6% of patients reported pain improvement and a further 21.2% maintained pain control based on FACT‐P prostate cancer‐specific pain scores. The most common treatment‐related grade ≥3 AEs were neutropenia (7.9%) and anaemia (2.1%). Conclusion Patients in CAPRISTANA treated with cabazitaxel had similar disease outcomes and safety profiles compared with large phase III clinical trials. Most patients had maintained or improved HRQoL scores; >70% of patients had maintained or improved pain control.
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Affiliation(s)
- Joan Carles
- Vall d'Hebron Institute of Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Angelika Pichler
- Department of Hematology and Oncology, Landeskrankenhaus Hochsteiermark, Leoben, Austria
| | - Hana Korunkova
- Department of Oncology and Radiotherapy, University Hospital, Plzen, Czech Republic
| | - Antoaneta Tomova
- Department of Oncology, Complex Oncology Center, Plovdiv, Bulgaria
| | - Marwan Ghosn
- Department of Hematology and Oncology, Hotel Dieu de France University Hospital, Saint Joseph University, Beirut, Lebanon
| | - Fadi El Karak
- Department of Hematology and Oncology, Hotel Dieu de France University Hospital, Saint Joseph University, Beirut, Lebanon
| | - Joseph Makdessi
- Department of Medicine, St. George Hospital, Beirut, Lebanon
| | - Irina Koroleva
- Department of Medicine, Medical University "Reaviz", Samara, Russia
| | - Gisoo Barnes
- Department of Clinical Outcomes, Sanofi, Cambridge, MA, USA
| | - Denise Bury
- Department of Clinical Outcomes, Sanofi, Cambridge, MA, USA
| | - Ayse Özatilgan
- Global Medical Affairs Oncology, Sanofi, Cambridge, MA, USA
| | - Simon Hitier
- Department of Biostatistics, Sanofi, Chilly-Mazarin, France
| | - Jana Katolicka
- Department of Oncology, St. Ann's University Hospital, Brno, Czech Republic
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Joachim C, Veronique-Baudin J, Almont T, Ulric-Gervaise S, Macni J, Pierre-Louis O, Godaert L, Drame M, Novella JL, Farid K, Vinh-Hung V, Escarmant P. Cohort profile: the Martinique Cancer Registry and the quality of life prostate cancer cohort (QoL Prostate-MQ): challenges and prospects for reducing disparities in the Caribbean. BMJ Open 2018; 8:e021540. [PMID: 30049695 PMCID: PMC6067331 DOI: 10.1136/bmjopen-2018-021540] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
PURPOSE Recording cancer data in cancer registries is essential for producing reliable population-based data for service planning, monitoring and evaluation. Prostate cancer (PCa) remains the most frequent type of cancer in terms of incidence and mortality in men in the Caribbean. The quality of life PCa cohort will assess quality of life and patient outcomes in Martinique using a digital platform for patient-reported outcome measures. PARTICIPANTS The Martinique Cancer Registry database is the largest clinical database among the French population-based cancer registries in the Caribbean, including more than 38 000 cancer cases, with 1650 new cancer cases per year, including 550 new PCa cases per year (2010-2014 latest period). In 2018, follow-up will include vital status, assessment of quality of life with the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (QLQ) Core 30 and the Prostate cancer module QLQ-PR25. Urinary incontinence and erectile dysfunction recorded prior to treatment will be analysed 1 and 5 years after treatment. FINDINGS TO DATE The registry includes data on circumstances of diagnosis, clinical stage at diagnosis. For PCa, the registry includes blood prostate-specific antigen level at the time of diagnosis, Gleason score and primary treatment. FUTURE PLANS Further studies will provide detailed data regarding the quality of diagnosis and management of patients with PCa in Martinique; analysing quality of care will be the next challenge.Quality of life and patient outcomes will be evaluated using a digital platform for patient-reported outcome measurement and electronic records.
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Affiliation(s)
- Clarisse Joachim
- UF1441 Registre des cancers de la Martinique, Pôle de Cancérologie Hématologie Urologie Pathologie, CHU Martinique, Fort-de-France, Martinique
| | - Jacqueline Veronique-Baudin
- UF1441 Registre des cancers de la Martinique, Pôle de Cancérologie Hématologie Urologie Pathologie, CHU Martinique, Fort-de-France, Martinique
| | - Thierry Almont
- Groupe d’Étude, de Formation et de Recherche en Andrologie, Urologie et Sexologie Médecine de la Reproduction, Toulouse, France
- Groupe de recherche en fertilité humaine, CHU Toulouse Paule de Viguier, Toulouse, France
| | - Stephen Ulric-Gervaise
- UF1441 Registre des cancers de la Martinique, Pôle de Cancérologie Hématologie Urologie Pathologie, CHU Martinique, Fort-de-France, Martinique
| | - Jonathan Macni
- UF1441 Registre des cancers de la Martinique, Pôle de Cancérologie Hématologie Urologie Pathologie, CHU Martinique, Fort-de-France, Martinique
| | - Olivier Pierre-Louis
- Pôle de Cancérologie Hématologie Urologie Pathologie, CHU Martinique, Fort-de-France, Martinique
| | - Lidvine Godaert
- Pôle de Gériatrie, CHU de Martinique, Fort-de-France, Martinique
| | - Moustapha Drame
- Unité d’aide Méthodologique, Pôle Recherche et Santé publique, CHU de Reims, Reims, France
- EA 3797, Université de Reims Champagne-Ardenne, Faculté de Médecine, Reims, France
| | - Jean-Luc Novella
- EA 3797, Université de Reims Champagne-Ardenne, Faculté de Médecine, Reims, France
- Département de Médecine Interne et Gériatrie, CHU de Reims, Reims, France
| | - Karim Farid
- Service de Médecine nucléaire, Pole d’imagerie Médicale, CHU Martinique, Fort-de-France, Martinique
| | - Vincent Vinh-Hung
- Pôle de Cancérologie Hématologie Urologie Pathologie, CHU Martinique, Fort-de-France, Martinique
| | - Patrick Escarmant
- Pôle de Cancérologie Hématologie Urologie Pathologie, CHU Martinique, Fort-de-France, Martinique
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Thiruchelvam N, Joyce A, Speakman M, Catto JWF, Hagan P, Fowler S, Hermans L, Keeley F. Improving Standards of Care through the Publication of Surgeon Identifiable Outcome Data in Urology. Eur Urol 2018; 74:1-3. [PMID: 29501450 DOI: 10.1016/j.eururo.2018.02.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 02/13/2018] [Indexed: 11/18/2022]
Abstract
Consultant Outcomes Publication aims to drive up standards of care by greater transparency and peer comparison of surgical practice and outcomes. This is despite difficulties of data entry and bias, and potential for risk avoidance and diminished training.
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Affiliation(s)
| | | | - Mark Speakman
- Musgrove Park Hospital NHS Trust, Taunton, Somerset, UK
| | - James W F Catto
- Academic Urology Unit, University of Sheffield, Sheffield, UK
| | | | - Sarah Fowler
- British Association of Urological Surgeons, London, UK
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Development of Indicators to Assess Quality of Care for Prostate Cancer. Eur Urol Focus 2018; 4:57-63. [DOI: 10.1016/j.euf.2016.01.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 01/25/2016] [Indexed: 11/16/2022]
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39
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Schroeck FR, Jacobs BL, Bhayani SB, Nguyen PL, Penson D, Hu J. Cost of New Technologies in Prostate Cancer Treatment: Systematic Review of Costs and Cost Effectiveness of Robotic-assisted Laparoscopic Prostatectomy, Intensity-modulated Radiotherapy, and Proton Beam Therapy. Eur Urol 2017; 72:712-735. [PMID: 28366513 PMCID: PMC5623181 DOI: 10.1016/j.eururo.2017.03.028] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 03/17/2017] [Indexed: 02/02/2023]
Abstract
CONTEXT Some of the high costs of robot-assisted radical prostatectomy (RARP), intensity-modulated radiotherapy (IMRT), and proton beam therapy may be offset by better outcomes or less resource use during the treatment episode. OBJECTIVE To systematically review the literature to identify the key economic trade-offs implicit in a particular treatment choice for prostate cancer. EVIDENCE ACQUISITION We systematically reviewed the literature according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement and protocol. We searched Medline, Embase, and Web of Science for articles published between January 2001 and July 2016, which compared the treatment costs of RARP, IMRT, or proton beam therapy to the standard treatment. We identified 37, nine, and three studies, respectively. EVIDENCE SYNTHESIS RARP is costlier than radical retropubic prostatectomy for hospitals and payers. However, RARP has the potential for a moderate cost advantage for payers and society over a longer time horizon when optimal cancer and quality-of-life outcomes are achieved. IMRT is more expensive from a payer's perspective compared with three-dimensional conformal radiotherapy, but also more cost effective when defined by an incremental cost effectiveness ratio <$50 000 per quality-adjusted life year. Proton beam therapy is costlier than IMRT and its cost effectiveness remains unclear given the limited comparative data on outcomes. Using the Grades of Recommendation, Assessment, Development and Evaluation approach, the quality of evidence was low for RARP and IMRT, and very low for proton beam therapy. CONCLUSIONS Treatment with new versus traditional technologies is costlier. However, given the low quality of evidence and the inconsistencies across studies, the precise difference in costs remains unclear. Attempts to estimate whether this increased cost is worth the expense are hampered by the uncertainty surrounding improvements in outcomes, such as cancer control and side effects of treatment. If the new technologies can consistently achieve better outcomes, then they may be cost effective. PATIENT SUMMARY We review the cost and cost effectiveness of robot-assisted radical prostatectomy, intensity-modulated radiotherapy, and proton beam therapy in prostate cancer treatment. These technologies are costlier than their traditional counterparts. It remains unclear whether their use is associated with improved cure and reduced morbidity, and whether the increased cost is worth the expense.
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Affiliation(s)
- Florian Rudolf Schroeck
- White River Junction VA Medical Center, White River Junction, VT, USA; Section of Urology and Norris Cotton Cancer Center, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA; The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth College, Lebanon, NH, USA.
| | - Bruce L Jacobs
- Department of Urology, University of Pittsburgh, Pittsburgh, PA, USA; Center for Research on Health Care, Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Sam B Bhayani
- Division of Urology, Washington University School of Medicine, St Louis, MO, USA
| | - Paul L Nguyen
- Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA, USA
| | - David Penson
- Department of Urologic Surgery, Vanderbilt University, Nashville, TN, USA; VA Tennessee Valley Geriatric Research, Education, and Clinical Center (GRECC), Nashville, TN, USA
| | - Jim Hu
- Department of Urology, Weill Cornell Medical College/New York-Presbyterian Hospital, New York, NY, USA
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Chaloupka M, Herlemann A, Spek A, Gratzke C, Stief C. [Cytoreductive, radical prostatectomy in metastatic prostate cancer]. Urologe A 2017; 56:1430-1434. [PMID: 28983651 DOI: 10.1007/s00120-017-0505-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The resection of the primary tumor in patients with metastatic prostate cancer is controversially debated. Retrospective clinical studies indicate survival benefits and prevention of secondary, locoregional complications; however, results of ongoing multicenter prospective studies are still lacking. This review highlights the rationale behind the cytoreductive prostatectomy and summarizes current clinical study results.
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Affiliation(s)
- M Chaloupka
- Urologische Klinik und Poliklinik, Campus Großhadern, Klinikum der Universität München, Ludwig-Maximilians Universität München, Marchioninistr. 15, 81377, München, Deutschland.
| | - A Herlemann
- Urologische Klinik und Poliklinik, Campus Großhadern, Klinikum der Universität München, Ludwig-Maximilians Universität München, Marchioninistr. 15, 81377, München, Deutschland
| | - A Spek
- Urologische Klinik und Poliklinik, Campus Großhadern, Klinikum der Universität München, Ludwig-Maximilians Universität München, Marchioninistr. 15, 81377, München, Deutschland
| | - C Gratzke
- Urologische Klinik und Poliklinik, Campus Großhadern, Klinikum der Universität München, Ludwig-Maximilians Universität München, Marchioninistr. 15, 81377, München, Deutschland
| | - C Stief
- Urologische Klinik und Poliklinik, Campus Großhadern, Klinikum der Universität München, Ludwig-Maximilians Universität München, Marchioninistr. 15, 81377, München, Deutschland
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Chien GW, Slezak JM, Harrison TN, Jung H, Gelfond JS, Zheng C, Wu E, Contreras R, Loo RK, Jacobsen SJ. Health-related quality of life outcomes from a contemporary prostate cancer registry in a large diverse population. BJU Int 2017; 120:520-529. [DOI: 10.1111/bju.13843] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Gary W. Chien
- Department of Urology; Kaiser Permanente Los Angeles Medical Center; Los Angeles CA USA
| | - Jeff M. Slezak
- Department of Research and Evaluation; Kaiser Permanente Southern California; Pasadena CA USA
| | - Teresa N. Harrison
- Department of Research and Evaluation; Kaiser Permanente Southern California; Pasadena CA USA
| | - Howard Jung
- Department of Urology; Kaiser Permanente; Honolulu HI USA
| | - Joy S. Gelfond
- Department of Research and Evaluation; Kaiser Permanente Southern California; Pasadena CA USA
| | - Chengyi Zheng
- Department of Research and Evaluation; Kaiser Permanente Southern California; Pasadena CA USA
| | - Edward Wu
- Department of Research and Evaluation; Kaiser Permanente Southern California; Pasadena CA USA
| | - Richard Contreras
- Department of Research and Evaluation; Kaiser Permanente Southern California; Pasadena CA USA
| | - Ronald K. Loo
- Department of Urology; Kaiser Permanente Downey Medical Center; Downey CA USA
| | - Steven J. Jacobsen
- Department of Research and Evaluation; Kaiser Permanente Southern California; Pasadena CA USA
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Pang KH, Rosario DJ, Morgan SL, Catto JWF. Evaluation of a short RNA within Prostate Cancer Gene 3 in the predictive role for future cancer using non-malignant prostate biopsies. PLoS One 2017; 12:e0175070. [PMID: 28380027 PMCID: PMC5381913 DOI: 10.1371/journal.pone.0175070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Accepted: 03/20/2017] [Indexed: 11/18/2022] Open
Abstract
Background Prostate Cancer 3 (PCA3) is a long non-coding RNA (ncRNA) upregulated in prostate cancer (PCa). We recently identified a short ncRNA expressed from intron 1 of PCA3. Here we test the ability of this ncRNA to predict the presence of cancer in men with a biopsy without PCa. Methods We selected men whose initial biopsy did not identify PCa and selected matched cohorts whose subsequent biopsies revealed PCa or benign tissue. We extracted RNA from the initial biopsy and measured PCA3-shRNA2, PCA3 and PSA (qRT-PCR). Results We identified 116 men with and 94 men without an eventual diagnosis of PCa in 2–5 biopsies (mean 26 months), collected from 2002–2008. The cohorts were similar for age, PSA and surveillance period. We detected PSA and PCA3-shRNA2 RNA in all samples, and PCA3 RNA in 90% of biopsies. The expression of PCA3 and PCA3-shRNA2 were correlated (Pearson’s r = 0.37, p<0.01). There was upregulation of PCA3 (2.1-fold, t-test p = 0.02) and PCA3-shRNA2 (1.5-fold) in men with PCa on subsequent biopsy, although this was not significant for the latter RNA (p = 0.2). PCA3 was associated with the future detection of PCa (C-index 0.61, p = 0.01). This was not the case for PCA3-shRNA2 (C-index 0.55, p = 0.2). Conclusions PCA3 and PCA3-shRNA2 expression are detectable in historic biopsies and their expression is correlated suggesting co-expression. PCA3 expression was upregulated in men with PCa diagnosed at a future date, the same did not hold for PCA3-shRNA2. Futures studies should explore expression in urine and look at a time course between biopsy and PCa detection.
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Affiliation(s)
- Karl H. Pang
- Academic Urology Unit and Academic Unit of Molecular Oncology, Department of Oncology and Human Metabolism, University of Sheffield, Sheffield, United Kingdom
| | - Derek J. Rosario
- Academic Urology Unit and Academic Unit of Molecular Oncology, Department of Oncology and Human Metabolism, University of Sheffield, Sheffield, United Kingdom
| | - Susan L. Morgan
- Department of Histopathology, Royal Hallamshire Hospital, Sheffield, United Kingdom
| | - James W. F. Catto
- Academic Urology Unit and Academic Unit of Molecular Oncology, Department of Oncology and Human Metabolism, University of Sheffield, Sheffield, United Kingdom
- * E-mail:
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Spek A, Herlemann A, Gratzke C, Stief CG. [Radical prostatectomy as part of a multimodal concept for patients with prostate cancer and bone metastases at initial diagnosis]. Urologe A 2017; 56:595-598. [PMID: 28314969 DOI: 10.1007/s00120-017-0366-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
In patients with metastatic prostate cancer presenting with synchronous bone metastases, the surgical removal of the primary is an experimental treatment approach. In the following article, we evaluate the rationale for this approach.
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Affiliation(s)
- A Spek
- Urologische Klinik des Klinikums der Universität München, Ludwig-Maximilians-Universität, Marchioninistr. 15, 81377, München, Deutschland
| | - A Herlemann
- Urologische Klinik des Klinikums der Universität München, Ludwig-Maximilians-Universität, Marchioninistr. 15, 81377, München, Deutschland
| | - C Gratzke
- Urologische Klinik des Klinikums der Universität München, Ludwig-Maximilians-Universität, Marchioninistr. 15, 81377, München, Deutschland
| | - C G Stief
- Urologische Klinik des Klinikums der Universität München, Ludwig-Maximilians-Universität, Marchioninistr. 15, 81377, München, Deutschland.
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Penson DF, Lin DW, Karsh L, Quinn DI, Shevrin DH, Shore N, Symanowski JT, Brown B, Forer D, Wong EK, Flanders SC. Treatment registry for outcomes in patients with castration-resistant prostate cancer (TRUMPET): a methodology for real-world evidence and research. Future Oncol 2016; 12:2689-2699. [PMID: 27528114 PMCID: PMC5116579 DOI: 10.2217/fon-2016-0298] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2006] [Accepted: 07/12/2016] [Indexed: 01/08/2023] Open
Abstract
AIM This study seeks to improve the understanding of treatment patterns and associated health-related quality of life (HRQoL), clinical outcomes and healthcare utilization in US patients with castration-resistant prostate cancer (CRPC). PATIENTS & METHODS Treatment Registry for Outcomes in CRPC Patients (TRUMPET) is a US-based, prospective, observational multicenter registry (NCT02380274) involving patients with CRPC and their caregivers. Patients initiating their first active treatment course will be enrolled from urology and medical oncology practices, with data captured up to 4 years. RESULTS Information on prescribing patterns, HRQoL, clinical outcomes and healthcare utilization will be collected. CONCLUSION TRUMPET will enable scientific understanding of disease management in terms of HRQoL, clinical outcomes and healthcare utilization in clinical practice for patients with CRPC.
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Affiliation(s)
- David F Penson
- Vanderbilt University Medical Center, Nashville, TN, USA
| | | | | | - David I Quinn
- USC Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | | | - Neal Shore
- Carolina Urologic Research Center, Myrtle Beach, SC, USA
| | - James T Symanowski
- Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC, USA
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Ruseckaite R, Beckmann K, O’Callaghan M, Roder D, Moretti K, Millar J, Evans S. A retrospective analysis of Victorian and South Australian clinical registries for prostate cancer: trends in clinical presentation and management of the disease. BMC Cancer 2016; 16:607. [PMID: 27496055 PMCID: PMC4974765 DOI: 10.1186/s12885-016-2655-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 07/30/2016] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Prostate cancer (PCa) is the most commonly diagnosed malignancy reported to Australian cancer registries with numerous studies from individual registries summarizing diagnostic and treatment characteristics. The aim of this study was to describe annual trends in clinical and treatment characteristics, and changes in surveillance practice within a large combined cohort of men with PCa in South Australia (SA) and Victoria, Australia in 2008-2013. METHODS Common data items from clinical registries in SA and Victoria were merged to develop a cross-jurisdictional dataset consisting of 13,598 men with PCa. Frequencies were used to describe these variables using the National Comprehensive Cancer Network risk of disease progression categories in 10 year age groups. A logistic regression analysis was performed to assess the impact of a number of factors (both individually and together) on the likelihood of men receiving no active treatment within twelve months of the diagnosis (i.e. managed with active surveillance/watchful waiting). RESULTS Trend analysis showed that over time: (1) men in SA and Victoria are being diagnosed at older age in 2013, 66.1 (SD = 9.7) years compared to 2009 (64.5 (SD = 9.7)); (2) diagnostic methods and characteristics have changed with time; and (3) types of the treatments have changed, with more men having no active treatment. The majority of men were diagnosed with Prostate-Specific Antigen (PSA) <10 ng/mL (66 %) and Grade Group < 4 (65 %). Nearly seventy percent received radical treatment within 12 months of diagnosis, while ~20 % had no active treatment. In 14 % of cases treatment was not recorded or had not commenced. Having no active treatment was strongly associated older age, lower PSA and lower Grade Group at diagnosis, and in 2013 it was offered more frequently (more than 3 times) than in 2009 (OR = 2.63, 95 % CI: 2.16-3.22). CONCLUSIONS Findings of this study provide the first cross-jurisdictional description of PCa characteristics and management in Australia. These findings will provide benchmarking for ongoing monitoring and feedback of disease management and outcomes of PCa through the Prostate Cancer Outcomes Registry-Australia New Zealand to improve evidence-based practice.
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Affiliation(s)
- Rasa Ruseckaite
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC Australia
| | - Kerri Beckmann
- Centre for Population Health Research, Sansom Institute for Health Research, University of South Australia, Adelaide, SA Australia
| | - Michael O’Callaghan
- South Australian Prostate Cancer Clinical Outcomes Collaborative, Department of Urology, Repatriation General Hospital, Adelaide, SA Australia
- Flinders Centre for Innovation in Cancer, Flinders University, Adelaide, SA Australia
- Freemasons Foundation Centre for Men’s Health and Discipline of Medicine, University of Adelaide, Adelaide, SA Australia
| | - David Roder
- Centre for Population Health Research, Sansom Institute for Health Research, University of South Australia, Adelaide, SA Australia
| | - Kim Moretti
- Centre for Population Health Research, Sansom Institute for Health Research, University of South Australia, Adelaide, SA Australia
- South Australian Prostate Cancer Clinical Outcomes Collaborative, Department of Urology, Repatriation General Hospital, Adelaide, SA Australia
- Flinders Centre for Innovation in Cancer, Flinders University, Adelaide, SA Australia
- Freemasons Foundation Centre for Men’s Health and Discipline of Medicine, University of Adelaide, Adelaide, SA Australia
| | - Jeremy Millar
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC Australia
- Radiation Oncology, Alfred Health, Melbourne, VIC Australia
| | - Sue Evans
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC Australia
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Gandaglia G, Bray F, Cooperberg MR, Karnes RJ, Leveridge MJ, Moretti K, Murphy DG, Penson DF, Miller DC. Reply from Authors re: Julia Verne, Luke Hounsome, Roger Kockelbergh, Jem Rashbass. Improving Outcomes from Prostate Cancer: Unlocking the Treasure Trove of Information in Cancer Registries. Eur Urol 2016;69:1013-4. Eur Urol 2016; 69:1015. [PMID: 26443428 DOI: 10.1016/j.eururo.2015.09.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Accepted: 09/23/2015] [Indexed: 10/22/2022]
Affiliation(s)
- Giorgio Gandaglia
- Unit of Urology/Department of Oncology, IRCCS San Raffaele Hospital, Milan, Italy.
| | - Freddie Bray
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Matthew R Cooperberg
- Departments of Urology and Epidemiology & Biostatistics, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | | | | | - Kim Moretti
- South Australian Prostate Cancer Clinical Outcomes Collaborative, Repatriation General Hospital, Daw Park, and the University of South Australia and the University of Adelaide, South Australia, Australia
| | - Declan G Murphy
- Division of Cancer Surgery, University of Melbourne, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - David F Penson
- Department of Urologic Surgery, Vanderbilt University, and the VA Tennessee Valley Geriatric Research, Education, and Clinical Center (GRECC), Nashville, TN, USA
| | - David C Miller
- Division of Urologic Oncology, Department of Urology, University of Michigan, Ann Arbor, MI, USA
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Craft PS. Improving quality in prostate cancer. Med J Aust 2016; 204:290. [DOI: 10.5694/mja16.00161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 02/26/2016] [Indexed: 11/17/2022]
Affiliation(s)
- Paul S Craft
- The Canberra Hospital, Canberra, ACT
- Australian National University, Canberra, ACT
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Zhou CK, Check DP, Lortet-Tieulent J, Laversanne M, Jemal A, Ferlay J, Bray F, Cook MB, Devesa SS. Prostate cancer incidence in 43 populations worldwide: An analysis of time trends overall and by age group. Int J Cancer 2016; 138:1388-400. [PMID: 26488767 PMCID: PMC4712103 DOI: 10.1002/ijc.29894] [Citation(s) in RCA: 191] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 10/08/2015] [Accepted: 10/15/2015] [Indexed: 01/09/2023]
Abstract
Prostate cancer is a significant public health burden and a major cause of morbidity and mortality among men worldwide. Analyzing geographic patterns and temporal trends may help identify high-risk populations, suggest the degree of PSA testing, and provide clues to etiology. We used incidence data available from the International Agency for Research on Cancer (IARC) and certain cancer registries for 43 populations across five continents during a median period of 24 years. Trends in overall prostate cancer rates showed five distinct patterns ranging from generally monotonic increases to peaking of rates followed by declines, which coincide somewhat with changes in the prevalence of PSA testing. Trends in age-specific rates generally mirrored those in the overall rates, with several notable exceptions. For populations where overall rates increased rapidly and then peaked, exemplified in North America and Oceania, the highest incidence tended to be most pronounced and occurred during earlier calendar years among older men compared with younger ones. For populations with almost continual increases in overall rates, exemplified in Eastern Europe and Asia, peaks were evident among men aged ≥ 75 years in many instances. Rates for ages 45-54 years did not clearly stabilize or decline in the majority of studied populations. Global geographic variation remained substantial for both overall and age-specific incidence rates regardless of levels of PSA testing, with the lowest rates consistently in Asia. Explanations for the persistent geographic differences and the continuing increases of especially early-onset prostate cancer remain unclear.
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Affiliation(s)
- Cindy Ke Zhou
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - David P. Check
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | | | - Mathieu Laversanne
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Ahmedin Jemal
- Surveillance and Health Services Research, American Cancer Society, Atlanta, GA, USA
| | - Jacques Ferlay
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Freddie Bray
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Michael B. Cook
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Susan S. Devesa
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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Ong WL, Evans SM, Spelman T, Kearns PA, Murphy DG, Millar JL. Comparison of oncological and health-related quality of life outcomes between open and robot-assisted radical prostatectomy for localised prostate cancer - findings from the population-based Victorian Prostate Cancer Registry. BJU Int 2015; 118:563-9. [DOI: 10.1111/bju.13380] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Wee Loon Ong
- Department of Urology; Alfred Health; Melbourne Vic. Australia
- Department of Epidemiology and Preventive Medicine; Monash University; Melbourne Vic. Australia
| | - Sue M. Evans
- Department of Epidemiology and Preventive Medicine; Monash University; Melbourne Vic. Australia
| | - Tim Spelman
- Department of Epidemiology and Preventive Medicine; Monash University; Melbourne Vic. Australia
- Centre for Population Health; Burnet Institute; Monash University; Melbourne Vic. Australia
| | - Paul A. Kearns
- Department of Urology; Barwon Health; Geelong Vic. Australia
| | - Declan G. Murphy
- Division of Cancer Surgery Peter MacCallum Cancer Centre; Melbourne Vic. Australia
- Epworth Prostate Centre; Epworth Healthcare; Melbourne Vic. Australia
| | - Jeremy L. Millar
- Department of Epidemiology and Preventive Medicine; Monash University; Melbourne Vic. Australia
- Department of Radiation Oncology; Alfred Health; Melbourne Vic. Australia
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50
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Editorial Comment. Urology 2015; 87:86-7. [PMID: 26656440 DOI: 10.1016/j.urology.2015.07.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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