Multidisciplinary Care and Pursuit of Active Surveillance in Low-Risk Prostate Cancer

Aizer, Ayal A.; Paly, Jonathan J.; Zietman, Anthony L.; Nguyen, Paul L.; Beard, Clair J.; Rao, Sandhya K.; Kaplan, Irving; Niemierko, Andrzej; Hirsch, Michelle S.; Wu, Chin‐Lee; Olumi, Aria F.; Michaelson, M. Dror; D’Amico, Anthony V.; Efstathiou, Jason A.

doi:10.1200/jco.2012.42.8466

Cited by 126 publications

(62 citation statements)

References 26 publications

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“…Spouses of these married patients may encourage them to perform surgery versus expectant management 28, which could partly account for the discrepancies. Studies showed diagnosis of cancer caused more distress than other diseases 29.…”

Section: Discussionmentioning

confidence: 99%

Marital status and survival in patients with gastric cancer

et al. 2016

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The objective of this study is to examine the impact of marital status on incidence of metastasis at diagnosis, receipt of surgery, and cause‐specific survival (CSS) in patients with gastric cancer (GC). Research data is extracted from The Surveillance, Epidemiology, and End Results (SEER) database, and 18,196 patients diagnosed with GC from 2004 to 2010 are involved. Effects of marital status on incidence of metastasis at diagnosis, receipt of surgery, and CSS are determined using multivariable logistic regression and multivariable Cox regression models, as appropriate. Single GC patients have a higher incidence of metastasis at diagnosis than married patients, while the differences between divorced/separated patients or widowed patients and married patients are not significant. Among those without distant metastasis, single patients, divorced/separated patients, and widowed patients are much less likely to accept surgery compared with married patients. Finally, in the whole group of 18,196 GC patients, single patients, divorced/separated patients, and widowed patients have shorter CSS compared with married patients, even in each of the TNM stage. Marriage had a protective effect against undertreatment and cause‐specific mortality (CSM) in GC. Spousal support may contribute to higher rate of surgery receipt and better survival in patients with GC.

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Section: Discussionmentioning

confidence: 99%

Marital status and survival in patients with gastric cancer

et al. 2016

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“…Although one correlational study detected that patients from multidisciplinary clinics were more likely to receive AS than patients under the care of individual practitioners, 46 there is insufficient evidence to address the factors affecting the offer of, acceptance of, and adherence to AS. There is also insufficient evidence to make recommendations with regard to the personnel who should be responsible for the management of AS protocols.…”

Section: Further Qualifying Statementsmentioning

confidence: 99%

Active surveillance for the management of localized prostate cancer: Guideline recommendations

Morash

Tey

Agbassi

et al. 2015

CUAJ

197

131

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Introduction: The objective is to provide guidance on the role of active surveillance (AS) as a management strategy for low-risk prostate cancer patients and to ensure that AS is offered to appropriate patients assessed by a standardized protocol. Prostate cancer is often a slowly progressive or sometimes non-progressive indolent disease diagnosed at an early stage with localized tumours that are unlikely to cause morbidity or death. Standard active treatments for prostate cancer include radiotherapy (RT) or radical prostatectomy (RP), but the harms from over diagnosis and overtreatment are of a significant concern. AS is increasingly being considered as a management strategy to avoid or delay the potential harms caused by unnecessary radical treatment. Methods: A literature search of MEDLINE, EMBASE, the Cochrane library, guideline databases and relevant meeting proceedings was performed and a systematic review of identified evidence was synthesized to make recommendations relating to the role of AS in the management of localized prostate cancer. Results: No exiting guidelines or reviews were suitable for use in the synthesis of evidence for the recommendations, but 59 reports of primary studies were identified. Due to studies being either non-comparative or heterogeneous, pooled meta-analyses were not conducted. Conclusion:The working group concluded that for patients with low-risk (Gleason score ≤6) localized prostate cancer, AS is the preferred disease management strategy. Active treatment (RP or RT) is appropriate for patients with intermediate-risk (Gleason score 7) localized prostate cancer. For select patients with low-volume Gleason 3+4=7 localized prostate cancer, AS can be considered.

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“…After a long discussion it was decided, at least for the initial phase of the implementation, to leave the number as 50 in order to facilitate the organization of PCU in centers not particularly focused on prostate surgery. In addition, the evaluation of the case load of a PCU must pay particular attention to the number of patients on active surveillance, who should be considered as patients potentially undergoing radical treatments [33,37,38]. Another significant point of discussion was the mandatory participation of the uro-pathologists in the Interdisciplinary and Multiprofessional Team Meetings as member of the Core Team.…”

Section: Pcu Treatment and Observational Settingmentioning

confidence: 99%

“…Centers systematically proposing active surveillance are experiencing a decrease in the number of patients undergoing prostatectomy, radiotherapy or brachytherapy [33,37,38]. This new scenario was considered when the mandatory number of radical procedures was decided.…”

Section: Pcu Treatment and Observational Settingmentioning

confidence: 99%

Prostate Cancer Unit Initiative in Europe: A position paper by the European School of Oncology

Valdagni

Poppel

Aitchison

et al. 2015

Critical Reviews in Oncology/Hematology

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Multidisciplinary Care and Pursuit of Active Surveillance in Low-Risk Prostate Cancer

Abstract: Multidisciplinary care is associated with increased selection of active surveillance in men with low-risk prostate cancer. This finding may have an important clinical, social, and economic impact.

Cited by 126 publications

References 26 publications

Marital status and survival in patients with gastric cancer

Marital status and survival in patients with gastric cancer

Active surveillance for the management of localized prostate cancer: Guideline recommendations

Prostate Cancer Unit Initiative in Europe: A position paper by the European School of Oncology

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