Trends in Conservative Management for Low-risk Prostate Cancer in a Population-based Cohort of Australian Men Diagnosed Between 2009 and 2016

Ong, Wee Loon; Evans, Sue; Evans, Melanie; Tacey, Mark; Dodds, Lachlan; Kearns, Paul; Milne, Roger L.; Foroudi, Farshad; Millar, Jeremy

doi:10.1016/j.euo.2019.04.006

Cited by 25 publications

(26 citation statements)

References 9 publications

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“…The available administrative datasets do not include information on hormone therapy. Data on brachytherapy were incomplete and therefore excluded; it is not a common treatment, particularly in more recent years 8 …”

Section: Discussionmentioning

confidence: 99%

“…Data on brachytherapy were incomplete and therefore excluded; it is not a common treatment, particularly in more recent years. 8 Matching data on biopsy admissions were not available for 15.5% of men registered as having been diagnosed with prostate cancer. This may have been because a biopsy was not performed, but it is more likely that a biopsy was performed in an outpatient setting, such as the private rooms of a urologist.…”

Section: Limitationsmentioning

confidence: 99%

“…5 Widespread PSA testing of asymptomatic men has contributed to high rates of overdiagnosis and overtreatment of people with low risk prostate cancer in Australia, 6 but the use of radical treatment in such cases may be starting to decline, both here and overseas. 7,8 The treatment preferred by a patient depends on his understanding of the prognosis and the risks and benefits of the options. His choice may be influenced by how the information is presented, and not all patients receive information adequate for making a fully informed decision.…”

mentioning

confidence: 99%

“…As active therapy has significant side effects, including urinary incontinence and erectile dysfunction, overtreatment should be avoided 5 . Widespread PSA testing of asymptomatic men has contributed to high rates of overdiagnosis and overtreatment of people with low risk prostate cancer in Australia, 6 but the use of radical treatment in such cases may be starting to decline, both here and overseas 7,8 …”

mentioning

confidence: 99%

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Differences in treatment choices for localised prostate cancer diagnosed in private and public health services

Marvelde

Milne

Hornby³

et al. 2020

Medical Journal of Australia

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Objective: To compare treatments for localised prostate cancer for men diagnosed in private and public health services in Victoria. Design: Retrospective analysis of Victorian Cancer Registry data linked to population-based administrative health datasets. Setting, participants: 29 325 Victorian men diagnosed with prostate cancer during 2011-2017. Main outcome measures: Proportions of men in private and public health services receiving radical prostatectomy (with or without curative radiation therapy) or curative external beam radiation therapy alone within 12 months of diagnosis.

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Section: Discussionmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Differences in treatment choices for localised prostate cancer diagnosed in private and public health services

Marvelde

Milne

Hornby³

et al. 2020

Medical Journal of Australia

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“…Butler et al [24] announced the application of AS across the United States is gradually increasing, particularly for elderly males with favorable bGS 3 + 4 prostate cancer. Conservative management consisted mostly of AS and has been the preferred treatment option for elderly patients with low-risk prostate cancer [25]. Australian national statistics also showed higher rates of conservative managements in elderly patients [26].…”

Section: Discussionmentioning

confidence: 99%

Patients with Biopsy Gleason Score 3 + 4 Are Not Appropriate Candidates for Active Surveillance

Park¹,

Yoo²,

Cho³

et al. 2019

Urol Int

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Objective: The aim of this study was to evaluate the feasibility of including patients with biopsy Gleason score (bGS) 3 + 4 prostate cancer in an active surveillance (AS) protocol. Methods: A total of 615 patients underwent a radical prostatectomy and satisfied the following requirements: prostatespecific antigen ≤10 ng/dL, clinical stage T1c or T2a, 2 or fewer positive biopsy cores, and bGS 6 or 3 + 4 prostate cancer. The patients were divided into two groups according to their bGS (bGS 6 group, n = 534; bGS 3 + 4 group, n = 81). Results: The adverse pathological features were significantly higher in the bGS 3 + 4 group (16.7 vs. 49.4%, p < 0.001). Biochemical recurrence (BCR)-free survival was also significantly lower in this group (p < 0.001). In a multivariate analysis, clinical stage (odds ratio [OR] 2.026, p = 0.007), maximum percentage of biopsy core involvement (OR 1.015, p = 0.014), and bGS (OR 1.913, p = 0.030) were independent risk factors for adverse pathological features. However, the bGS was the only variable to forecast BCR (hazard ratio 3.567, p < 0.001). Conclusions:A bGS 3 + 4 was the leading risk factor for a worse postoperative prognosis. Therefore, patients with a bGS 3 + 4 are not appropriate candidates for AS.

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Use of Active Surveillance vs Definitive Treatment Among Men With Low- and Favorable Intermediate–Risk Prostate Cancer in the US Between 2010 and 2018

et al. 2023

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Trends in Conservative Management for Low-risk Prostate Cancer in a Population-based Cohort of Australian Men Diagnosed Between 2009 and 2016

Cited by 25 publications

References 9 publications

Differences in treatment choices for localised prostate cancer diagnosed in private and public health services

Differences in treatment choices for localised prostate cancer diagnosed in private and public health services

Patients with Biopsy Gleason Score 3 + 4 Are Not Appropriate Candidates for Active Surveillance

Use of Active Surveillance vs Definitive Treatment Among Men With Low- and Favorable Intermediate–Risk Prostate Cancer in the US Between 2010 and 2018

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