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Chang EM, Punglia RS, Steinberg ML, Raldow AC. Cost Effectiveness of the Oncotype DX Genomic Prostate Score for Guiding Treatment Decisions in Patients With Early Stage Prostate Cancer. Urology 2019; 126:89-95. [DOI: 10.1016/j.urology.2018.12.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 12/11/2018] [Accepted: 12/13/2018] [Indexed: 11/29/2022]
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2
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Palmer NR, Gregorich SE, Livaudais-Toman J, Jih J, Kaplan CP. Racial and Ethnic Differences in Prostate Cancer Survivors' Perceived Engagement in Treatment Decision-Making. J Racial Ethn Health Disparities 2018; 5:1273-1283. [PMID: 29516434 PMCID: PMC6526935 DOI: 10.1007/s40615-018-0475-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Revised: 02/19/2018] [Accepted: 02/23/2018] [Indexed: 01/07/2023]
Abstract
OBJECTIVE We examined prostate cancer patients' perceived engagement in treatment decision-making and associated factors by race/ethnicity in a multiethnic sample. METHOD We identified patients through the California Cancer Registry. Patients completed a cross-sectional telephone interview in English, Spanish, Cantonese, or Mandarin. Multivariable logistic regression models, stratified by race/ethnicity, estimated the associations of patient demographic and health status characteristics on (1) doctor asked patient to help decide treatment plan and (2) patient and doctor worked out a treatment plan together. RESULTS We included 855 prostate cancer patients: African American (19%), Asian American (15%), Latino (24%), and White (42%). Asian American patients were less likely than White patients to report that their doctors asked them to help decide a treatment plan (OR = 0.31; 95% CI = 0.18-0.53) and that they worked out a treatment plan with their doctors (OR = 0.54; 95% CI = 0.33-0.90). Language of interview was a significant contributing factor in stratified analysis for both outcomes. CONCLUSION Asian American prostate cancer patients reported less engagement in treatment decision-making, with Chinese language being a significant contributing factor. Future research should identify patient-centered strategies that effectively engage underserved patients and support healthcare providers in shared decision-making with multiethnic and multilingual patients.
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Affiliation(s)
- Nynikka R Palmer
- Division of General Internal Medicine at Zuckerberg San Francisco General Hospital, Department of Medicine, University of California, 1001 Potrero Avenue, Building 10, 3rd Floor, UCSF Box 1364, San Francisco, CA, 94143, USA.
| | - Steven E Gregorich
- Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Jennifer Livaudais-Toman
- Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Jane Jih
- Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Celia P Kaplan
- Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
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3
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Italian cultural adaptation of the Memorial Anxiety for Prostate Cancer scale for the population of men on active surveillance. TUMORI JOURNAL 2018. [DOI: 10.5301/tj.5000646] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose: The Memorial Anxiety Scale for Prostate Cancer (MAX-PC) is a self-report questionnaire that was developed in English to assess prostate cancer (PCa)-related anxiety. The aim of this study was to perform a cultural adaptation for the tool to be used in a population of Italian men on active surveillance (AS). Methods: A total of 222 patients with localized PCa who were recruited for the Prostate Cancer Research International: Active Surveillance (PRIAS) protocol completed the MAX-PC. Psychometric analysis was performed to assess reliability indexes. A Spearman rank correlation was used to test the association between MAX-PC scales and other questionnaires and was used for longitudinal analysis. Results: Cronbach coefficients and item to total correlation demonstrated good internal consistency. Some items related to the repetition of the PSA test showed a large floor effect and thus were poorly effective in measuring anxiety for PSA testing in patients on AS. Confirmatory factor analysis partly failed to reproduce the structure of the original version. A modified version of MAX-PC, excluding the items with a large floor effect, was thus considered for AS patients. Factor analysis on this version demonstrated considerable consistency with the presence of 3 subscales: anxiety related to PCa, anxiety related to PSA testing, and anxiety related to the fear of tumor progression. Longitudinal analysis showed an acceptable validity over time. The MAX-PC was correlated with the anxious preoccupation subscale of the Mini-Mental Adjustment to Cancer scale. Conclusions: A slightly modified version of the MAX-PC was developed for use in Italian men on AS. This instrument appears to be a valid and reliable tool that measures anxiety in men with PCa who are enrolled in AS programs.
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Ferlicot S. [Prostate cancer histoseminar: Update of the 2016 WHO classification - case No. 8: Acinar prostatic adenocarcinoma, Gleason score 6 (3+3)]. Ann Pathol 2017; 37:259-263. [PMID: 28522121 DOI: 10.1016/j.annpat.2017.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Accepted: 02/13/2017] [Indexed: 11/18/2022]
Affiliation(s)
- Sophie Ferlicot
- Service d'anatomie et cytologie pathologiques, hôpital de Bicêtre, hôpitaux universitaires Paris-Sud, université Paris-Sud, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre cedex, France.
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5
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Eredics K, Dorfinger K, Kramer G, Ponholzer A, Madersbacher S. Active surveillance for low-risk prostate cancer in Austria: the online registry of the Qualitätspartnerschaft Urologie (QuapU). Wien Klin Wochenschr 2016; 129:375-379. [PMID: 28004265 DOI: 10.1007/s00508-016-1149-8] [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: 08/17/2016] [Accepted: 11/28/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Active surveillance (AS) is a well-recognized strategy to reduce the risk of overtreatment in men with low-risk prostate cancer. No data on this approach are available from Austria. METHODS The Qualitätspartnerschaft Urologie (QuapU) developed an online database for patients managed with AS in Austria. Principal inclusion/exclusion criteria corresponded to those of the S3 prostate cancer guideline of German urologists: prostate-specific antigen (PSA) <10 ng/ml, Gleason score <7 (maximum 20% of biopsies being positive). Control visits were scheduled at 3‑month intervals, control biopsies were scheduled at 12 and 36 months. RESULTS To date 131 patients have been entered into this data base. Mean patient age is 64 years, 6% were younger than 50 years, two thirds of patients were aged 50-70 years and 25% were older than 70 years. Mean PSA value was 5.9 ng/ml (PSA 0-4 ng/ml: 15%; PSA >4-10 ng/ml: 85%). The prostate volume averaged 39 ml. The mean time under AS was 17.5 months (<12 months: 60%; >12 months: 40%). The AS adherence at 12 months was 85% and at 24 months 76%. To date, a total of 23 patients (17.6%) stopped AS. The most frequent reasons for discontinuing AS were patient wish for active treatment (43.5%) and PSA progression (30.4%). A histological progression was rarely seen (6.1%) and the control biopsy rate was low (19.8%). CONCLUSION This study is the first description of AS in Austria and documents the feasibility of an online registry for AS. The data confirm the international experience with this approach with acceptable adherence rates.
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Affiliation(s)
- Klaus Eredics
- Department of Urology, Kaiser-Franz-Josef Spital, Kundratstrasse 3, 1100, Vienna, Austria
| | | | - Gero Kramer
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Anton Ponholzer
- Department of Urology, Krankenhaus der Barmherzigen Brüder, Vienna, Austria
| | - Stephan Madersbacher
- Department of Urology, Kaiser-Franz-Josef Spital, Kundratstrasse 3, 1100, Vienna, Austria.
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Hall IJ, Lee Smith J. Evolution of a CDC Public Health Research Agenda for Low-Risk Prostate Cancer. Am J Prev Med 2015; 49:S483-8. [PMID: 26590643 PMCID: PMC4733621 DOI: 10.1016/j.amepre.2015.08.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 08/24/2015] [Accepted: 08/25/2015] [Indexed: 11/03/2022]
Abstract
Men with prostate cancer face difficult choices when selecting a therapy for localized prostate cancer. Comparative data from controlled studies are lacking and clinical opinions diverge about the benefits and harms of treatment options. Consequently, there is limited guidance for patients regarding the impact of treatment decisions on quality of life. There are opportunities for public health to intervene at several decision-making points. Information on typical quality of life outcomes associated with specific prostate cancer treatments could help patients select treatment options. From 2003 to present, the Division of Cancer Prevention and Control at CDC has supported projects to explore patient information-seeking behavior post-diagnosis, caregiver and provider involvement in treatment decision making, and patient quality of life following prostate cancer treatment. CDC's work also includes research that explores barriers and facilitators to the presentation of active surveillance as a viable treatment option and promotes equal access to information for men and their caregivers. This article provides an overview of the literature and considerations that initiated establishing a prospective public health research agenda around treatment decision making. Insights gathered from CDC-supported studies are poised to enhance understanding of the process of shared decision making and the influence of patient, caregiver, and provider preferences on the selection of treatment choices. These findings provide guidance about attributes that maximize patient experiences in survivorship, including optimal quality of life and patient and caregiver satisfaction with information, treatment decisions, and subsequent care.
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Affiliation(s)
- Ingrid J Hall
- Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia.
| | - Judith Lee Smith
- Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia
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Amin MB, Lin DW, Gore JL, Srigley JR, Samaratunga H, Egevad L, Rubin M, Nacey J, Carter HB, Klotz L, Sandler H, Zietman AL, Holden S, Montironi R, Humphrey PA, Evans AJ, Epstein JI, Delahunt B, McKenney JK, Berney D, Wheeler TM, Chinnaiyan AM, True L, Knudsen B, Hammond MEH. The critical role of the pathologist in determining eligibility for active surveillance as a management option in patients with prostate cancer: consensus statement with recommendations supported by the College of American Pathologists, International Society of Urological Pathology, Association of Directors of Anatomic and Surgical Pathology, the New Zealand Society of Pathologists, and the Prostate Cancer Foundation. Arch Pathol Lab Med 2014; 138:1387-405. [PMID: 25092589 DOI: 10.5858/arpa.2014-0219-sa] [Citation(s) in RCA: 98] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
CONTEXT Prostate cancer remains a significant public health problem. Recent publications of randomized trials and the US Preventive Services Task Force recommendations have drawn attention to overtreatment of localized, low-risk prostate cancer. Active surveillance, in which patients undergo regular visits with serum prostate-specific antigen tests and repeat prostate biopsies, rather than aggressive treatment with curative intent, may address overtreatment of low-risk prostate cancer. It is apparent that a greater awareness of the critical role of pathologists in determining eligibility for active surveillance is needed. OBJECTIVES To review the state of current knowledge about the role of active surveillance in the management of prostate cancer and to provide a multidisciplinary report focusing on pathologic parameters important to the successful identification of patients likely to succeed with active surveillance, to determine the role of molecular tests in increasing the safety of active surveillance, and to provide future directions. DESIGN Systematic review of literature on active surveillance for low-risk prostate cancer, pathologic parameters important for appropriate stratification, and issues regarding interobserver reproducibility. Expert panels were created to delineate the fundamental questions confronting the clinical and pathologic aspects of management of men on active surveillance. RESULTS Expert panelists identified pathologic parameters important for management and the related diagnostic and reporting issues. Consensus recommendations were generated where appropriate. CONCLUSIONS Active surveillance is an important management option for men with low-risk prostate cancer. Vital to this process is the critical role pathologic parameters have in identifying appropriate candidates for active surveillance. These findings need to be reproducible and consistently reported by surgical pathologists with accurate pathology reporting.
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Affiliation(s)
- Mahul B Amin
- From the Departments of Pathology and Laboratory Medicine (Drs Amin and Knudsen), Radiation Oncology (Dr Sandler), Urology (Dr Holden), and Biomedical Sciences (Dr Knudsen), Cedars-Sinai Medical Center, Los Angeles, California; the Departments of Urology (Drs Lin and Gore) and Pathology (Dr True), University of Washington, Seattle; Trillium Health Partners, Mississauga, Ontario, Canada, and McMaster University, Hamilton, Ontario, Canada (Dr Srigley); Aquesta Pathology, Toowong, Queensland, Australia, and the University of Queensland, Brisbane (Dr Samaratunga); the Department of Oncology and Pathology, Karolinska Institutet, Karolinska University Hospital, Solna, Stockholm, Sweden (Dr Egevad); the Institute for Precision Medicine and the Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University, Ithaca, New York, and New York-Presbyterian Hospital, New York (Dr Rubin); the Departments of Surgery (Dr Nacey) and Pathology and Molecular Medicine (Dr Delahunt), Wellington School of Medicine and Health Sciences, University of Otago, Newtown, Wellington, New Zealand; the James Buchanan Brady Urological Institute (Dr Carter) and the Departments of Pathology (Dr Epstein), Urology (Dr Epstein), and Oncology (Dr Epstein), Johns Hopkins School of Medicine, Baltimore, Maryland; Division of Urology, the Sunnybrook Health Sciences Centre (Dr Klotz) and the University Health Network (Dr Evans), University of Toronto, Toronto, Ontario, Canada; the Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston (Dr Zietman); the Section of Pathological Anatomy, Department of Biomedical Sciences and Public Health, Polytechnic University of the Marche Region, Ancona, Italy (Dr Montironi); the Department of Pathology, Yale University School of Medicine, New Haven, Connecticut (Dr Humphrey); the Pathology and Laboratory Medicine Institute, Cleveland Clinic Foundation, Cleveland, Ohio (Dr McKenney); the Department of Cell
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Patel HD, Humphreys E, Trock BJ, Han M, Carter HB. Practice patterns and individual variability of surgeons performing radical prostatectomy at a high volume academic center. J Urol 2014; 193:812-9. [PMID: 25196659 DOI: 10.1016/j.juro.2014.08.101] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2014] [Indexed: 01/22/2023]
Abstract
PURPOSE Regional and local variation in radical prostatectomy rates contribute to overtreatment of low risk prostate cancer. We hypothesized that individual practice variability would be minimal among urologists practicing at a high volume academic center. MATERIALS AND METHODS We assessed the percent of patients at low risk treated with radical prostatectomy in a given year and comorbidity adjusted life expectancy in an institutional database accounting for temporal trends and disease characteristics. Multivariable linear, spline and logistic models were applied with a hierarchical random effects model to estimate the proportion of variance due to surgeon and temporal effects. RESULTS Of the 20,655 men included in study 11,873 (57.5%) had low risk disease. The Gleason score leading to radical prostatectomy increased with time. Overall the percent of patients at low risk treated with prostatectomy in a given year increased 3.49% yearly from 1991 to 2001 and then decreased by 1.73% yearly from 2001 to 2013. Greater surgeon experience was associated with a higher percent of patients at low risk treated with prostatectomy in a given year from 1991 to 2001 (0.46% per year of experience). High volume surgeons (total more than 1,000 radical prostatectomies) operated on a slightly greater percent of patients at low risk (3.54%). Substantial practice variation existed among surgeons for operating on men 65 years old or older at low risk (OR 3.15, 95% CI 1.62-6.11). There was similar variation when operating on older patients with a life expectancy of less than 15 years. Surgeon level and temporal effects explained 24% and 70%, respectively, of the variance in the percent of patients at low risk treated with radical prostatectomy in a given year. CONCLUSIONS At a high volume academic center substantial practice variation exists among surgeons when selecting patients with prostate cancer to undergo radical prostatectomy based on risk and life expectancy even among older patients. In addition to patient decision support tools, publicly reporting individual practice patterns at the provider level could decrease the overtreatment of low risk prostate cancer.
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Affiliation(s)
- Hiten D Patel
- Center for Surgical Trials and Outcomes Research, Department of Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland.
| | - Elizabeth Humphreys
- The James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Bruce J Trock
- The James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Misop Han
- The James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - H Ballentine Carter
- The James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, Maryland
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9
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Venderbos LDF, van den Bergh RCN, Roobol MJ, Schröder FH, Essink-Bot ML, Bangma CH, Steyerberg EW, Korfage IJ. A longitudinal study on the impact of active surveillance for prostate cancer on anxiety and distress levels. Psychooncology 2014; 24:348-54. [PMID: 25138075 DOI: 10.1002/pon.3657] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Revised: 07/28/2014] [Accepted: 07/29/2014] [Indexed: 11/06/2022]
Affiliation(s)
- Lionne D. F. Venderbos
- Department of Urology; Erasmus Medical Center; Rotterdam The Netherlands
- Department of Public Health; Erasmus Medical Center; Rotterdam The Netherlands
| | | | - Monique J. Roobol
- Department of Urology; Erasmus Medical Center; Rotterdam The Netherlands
| | - Fritz H. Schröder
- Department of Urology; Erasmus Medical Center; Rotterdam The Netherlands
| | - Marie-Louise Essink-Bot
- Department of Public Health; Erasmus Medical Center; Rotterdam The Netherlands
- Department of Public Health; Academic Medical Center; Amsterdam The Netherlands
| | - Chris H. Bangma
- Department of Urology; Erasmus Medical Center; Rotterdam The Netherlands
| | - Ewout W. Steyerberg
- Department of Public Health; Erasmus Medical Center; Rotterdam The Netherlands
| | - Ida J. Korfage
- Department of Public Health; Erasmus Medical Center; Rotterdam The Netherlands
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Marks LS. Improving risk stratification in patients with prostate cancer managed by active surveillance: nomogram predicting the risk of biopsy progression. BJU Int 2014; 113:E13-4. [PMID: 24629086 DOI: 10.1111/bju.12306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Leonard S Marks
- Department of Urology, Geffen School of Medicine at the University of California Los Angeles (UCLA), Los Angeles, CA, USA.
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Morgans AK, Penson DF. The more, the merrier: including a medical oncologist in treatment planning for localized prostate cancer. J Oncol Pract 2014; 10:113-4. [PMID: 24399852 DOI: 10.1200/jop.2013.001247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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12
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Williams S, Chiong E, Lojanapiwat B, Umbas R, Akaza H. Management of prostate cancer in Asia: resource-stratified guidelines from the Asian Oncology Summit 2013. Lancet Oncol 2013; 14:e524-34. [PMID: 24176571 DOI: 10.1016/s1470-2045(13)70451-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Many local and systemic options for prostate cancer have emerged in recent years, but existing management guidelines do not account for diversity in health resources between different countries. We present recommendations for the management of prostate cancer, stratified according to the extent of resource availability-based on a four-tier system of basic, limited, enhanced, and maximum resources-to enable applicability to Asian countries with differing levels of health-care resources. This statement of recommendations was formulated by a multidisciplinary panel from Asia-Pacific countries, at a consensus session on prostate cancer that was held as part of the 2013 Asian Oncology Summit in Bangkok, Thailand.
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Affiliation(s)
- Scott Williams
- Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
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Patel HD, Feng Z, Landis P, Trock BJ, Epstein JI, Carter HB. Prostate specific antigen velocity risk count predicts biopsy reclassification for men with very low risk prostate cancer. J Urol 2013; 191:629-37. [PMID: 24060641 DOI: 10.1016/j.juro.2013.09.029] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2013] [Indexed: 01/01/2023]
Abstract
PURPOSE Prostate specific antigen velocity is an unreliable predictor of adverse pathology findings in patients on active surveillance for low risk prostate cancer. However, to our knowledge a new concept called prostate specific antigen velocity risk count, recently validated in a screening cohort, has not been investigated in an active surveillance cohort. MATERIALS AND METHODS We evaluated a cohort of men from 1995 to 2012 with prostate cancer on active surveillance. They had stage T1c disease, prostate specific antigen density less than 0.15 ng/ml, Gleason score 6 or less, 2 or fewer biopsy cores and 50% or less involvement of any core with cancer. The men were observed by semiannual prostate specific antigen measurements, digital rectal examinations and an annual surveillance biopsy. Treatment was recommended for biopsy reclassification. Patients with 30 months or greater of followup and 3 serial prostate specific antigen velocity measurements were used in primary analysis by logistic regression, Cox proportional hazards, Kaplan-Meier analysis and performance parameters, including the AUC of the ROC curve. RESULTS Primary analysis included 275 of 668 men who met very low risk inclusion criteria, of whom 83 (30.2%) were reclassified at a median of 57.1 months. Reclassification risk increased with risk count, that is a risk count of 3 (HR 4.63, 95% CI 1.54-13.87) and 2 (HR 3.73, 95% CI 1.75-7.97) compared to zero. Results were similar for Gleason score reclassification (HR 7.45, 95% CI 1.60-34.71 and 3.96, 95% CI 1.35-11.62, respectively). On secondary analysis the negative predictive value (risk count 1 or less) was 91.5% for reclassification in the next year. Adding the prostate specific antigen velocity risk count improved the AUC in a model including baseline prostate specific antigen density (0.7423 vs 0.6818, p = 0.025) and it outperformed the addition of overall prostate specific antigen velocity (0.7423 vs 0.6960, p = 0.037). CONCLUSIONS Prostate specific antigen velocity risk count may be useful for monitoring patients on active surveillance and decreasing the frequency of biopsies needed in the long term.
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Affiliation(s)
- Hiten D Patel
- James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, Maryland.
| | - Zhaoyong Feng
- James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Patricia Landis
- James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Bruce J Trock
- James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Jonathan I Epstein
- James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - H Ballentine Carter
- James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, Maryland
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