Prostate cancer outcomes and delays in care

O’Callaghan, Michael; Shi, Zumin; Kopsaftis, Tina; Moretti, Kim

doi:10.1007/s11255-017-1508-z

Cited by 8 publications

(5 citation statements)

References 16 publications

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“…Overall, PCa patients are more likely to delay treatment when compared to patients diagnosed with other cancer types. This delay may be in part due to the minimal to no significant impact on oncological outcomes when PCa treatment is delayed for a few months, especially for patients with low or intermediate risks (Helsper et al, 2017; Morini et al, 2018; O’Callaghan et al, 2017; Sun et al, 2012). Treatment delay in high-risk PCa patients has been associated with worse clinical outcomes (Fossati et al, 2017; Hsu et al, 2015; Qu et al, 2019; van den Bergh et al, 2013; Zanaty et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

Sociodemographic and Geographic Disparities of Prostate Cancer Treatment Delay in Tennessee: A Population-Based Study

et al. 2021

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The relationship of social determinants of health, Appalachian residence, and prostate cancer treatment delay among Tennessee adults is relatively unknown. We used multivariate logistic regression on 2005–2015 Tennessee Cancer Registry data of adults aged ≥18 diagnosed with prostate cancer. The outcome of treatment delay was more than 90 days without surgical or nonsurgical intervention from date of diagnosis. Social determinants in the population-based registry were race (White, Black, Other) and marital status (single, married, divorced/separated, widow/widower). Tennessee residence was classified as Appalachian versus non-Appalachian (urban/rural). Covariates include age at diagnosis (18–54, 54–69, ≥70), health insurance type (none, public, private), derived staging of cancer (localized, regional, distant), and treatment type (non-surgical/surgical). We found that Black and divorced/separated patients had 32% (95% confidence interval [CI]: 1.22–1.42) and 15% (95% CI: 1.01–1.31) increased odds to delay prostate cancer treatment. Patients were at decreased odds of treatment delay when living in an Appalachian county, both urban (odds ratio [OR] = 0.89, 95% CI: 0.82–0.95) and rural (OR = 0.83, 95% CI: 0.78–0.89), diagnosed at ≥70 (OR = 0.59, 95% CI: 0.53–0.66), and received surgical intervention (OR = 0.72, 95% CI: 0.68–0.76). Our study was among the first to comprehensively examine prostate cancer treatment delay in Tennessee, and while we do not make clinical recommendations, there is a critical need to further explore the unique factors that may propagate disparities. Prostate cancer treatment delay in Black patients may be indicative of ongoing health and access disparities in Tennessee, which may further affect quality of life and survivorship among this racial group. Divorced/separated patients may need tailored interventions to improve social support.

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Section: Discussionmentioning

confidence: 99%

Sociodemographic and Geographic Disparities of Prostate Cancer Treatment Delay in Tennessee: A Population-Based Study

et al. 2021

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“…A total of 21 studies [10,[18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] reported outcomes of delayed RP compared to immediate RP in low-risk patients. Amongst low-risk patients, evidence supporting the delay of RP are contradictory.…”

Section: Low Risk Patientsmentioning

confidence: 99%

“…A total of 11 studies [10,[18][19][20][21]24,26,29,30,34,36] reported outcomes of delayed RP compared to immediate RP in intermediate-risk patients. Delaying surgery for intermediate-risk patients generally leads to significantly worse oncological and pathological outcomes.…”

Section: Intermediate-risk Patientsmentioning

confidence: 99%

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Effects of Delayed Radical Prostatectomy and Active Surveillance on Localised Prostate Cancer—A Systematic Review and Meta-Analysis

Chan

Tan

Asif

et al. 2021

Cancers

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External factors, such as the coronavirus disease 2019 (COVID-19), can lead to cancellations and backlogs of cancer surgeries. The effects of these delays are unclear. This study summarised the evidence surrounding expectant management, delay radical prostatectomy (RP), and neoadjuvant hormone therapy (NHT) compared to immediate RP. MEDLINE and EMBASE was searched for randomised controlled trials (RCTs) and non-randomised controlled studies pertaining to the review question. Risks of biases (RoB) were evaluated using the RoB 2.0 tool and the Newcastle–Ottawa Scale. A total of 57 studies were included. Meta-analysis of four RCTs found overall survival and cancer-specific survival were significantly worsened amongst intermediate-risk patients undergoing active monitoring, observation, or watchful waiting but not in low- and high-risk patients. Evidence from 33 observational studies comparing delayed RP and immediate RP is contradictory. However, conservative estimates of delays over 5 months, 4 months, and 30 days for low-risk, intermediate-risk, and high-risk patients, respectively, have been associated with significantly worse pathological and oncological outcomes in individual studies. In 11 RCTs, a 3-month course of NHT has been shown to improve pathological outcomes in most patients, but its effect on oncological outcomes is apparently limited.

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“…Their study of 3149 men found that time to radical prostatectomy was not a predictor of BCR even in the high risk group of up to 12 months [8]. O'Callaghan et al also found no significant association with delay to treatment and prostate cancer specific mortality when analysing all risk groups [9]. Other reports have found results both in line with the above [10][11][12][13][14][15] or contradicting these results [16].…”

mentioning

confidence: 92%

Safety First: Evidence for Delay of Radical Prostatectomy without Use of Androgen Deprivation Therapy During COVID-19

et al. 2020

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Prostate cancer outcomes and delays in care

Cited by 8 publications

References 16 publications

Sociodemographic and Geographic Disparities of Prostate Cancer Treatment Delay in Tennessee: A Population-Based Study

Sociodemographic and Geographic Disparities of Prostate Cancer Treatment Delay in Tennessee: A Population-Based Study

Effects of Delayed Radical Prostatectomy and Active Surveillance on Localised Prostate Cancer—A Systematic Review and Meta-Analysis

Safety First: Evidence for Delay of Radical Prostatectomy without Use of Androgen Deprivation Therapy During COVID-19

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