181 Service Evaluation of the Utilisation and Impact of PredictProstate on Clinical Decision-Making in a Prostate Cancer Specialist Multidisciplinary Service

Abstract

Aim Patients with low and intermediate risk prostate cancer must decide whether to undergo radical treatment. The PredictProstate tool uses patient characteristics to quantify the relative benefit of radical treatment. It has been introduced in our prostate cancer specialist multidisciplinary team meeting (pcSMDT) and in subsequent communication with patients to facilitate informed decision-making. The aim of this study was to assess the utilisation and utility of PredictProstate in informing treatment decisions for men referred to Cambridge University Hospitals (CUH) for consideration of radical prostatectomy (RARP). Method A retrospective chart review was conducted of patients referred to the CUH pcSMDT and robotic prostatectomy clinic (ROPD) between Sep 2019 and Aug 2021 for consideration of RARP. Data on patient characteristics, use of PredictProstate, and management decisions was collected from the EPIC EMR. A total of 841 patients were included in the analysis. Results The usage of PredictProstate in the pcSMDT increased in the second half of the study period (34.5% vs 23.8%, p<0.001). The use of PredictProstate for men with low and intermediate risk prostate cancer was associated with an increased likelihood of attending ROPD (75% vs 61%, p<0.001), but a reduced likelihood of RARP (41% vs 55%, p<0.01). These effects were most pronounced for men of favourable intermediate risk (80% vs 63%, p<0.004 and 34% vs 54%, p<0.07 respectively). Conclusions PredictProstate provides personalised prognostic data for patients. Its increased use for men with low and intermediate risk prostate cancer is associated with increased attendance at specialist surgical clinic and a reduced chance of undergoing RARP.