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Abedlhafez A, Hosny K, El-Nahas AR, Liew M. The health-related quality of life in patients with prostate cancer managed with active surveillance using the Expanded Prostate Cancer Index Composite survey: Systematic review and meta-analysis. Arab J Urol 2022; 20:61-70. [PMID: 35530570 PMCID: PMC9067949 DOI: 10.1080/2090598x.2021.2024368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Objective Methods Results Conclusion
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Affiliation(s)
- Ahmed Abedlhafez
- Wrightington Wigan and Leigh Teaching Hospitals NHS Foundation Trust, Wigan, UK
| | - Khaled Hosny
- James Cook University Hospital, Middlesbrough, UK
| | | | - Matthew Liew
- Wrightington Wigan and Leigh Teaching Hospitals NHS Foundation Trust, Wigan, UK
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2
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Formica MK, Wason S, Seigne JD, Stewart TM. Impact of a decision aid on newly diagnosed prostate cancer patients' understanding of the rationale for active surveillance. PATIENT EDUCATION AND COUNSELING 2017; 100:812-817. [PMID: 27923674 DOI: 10.1016/j.pec.2016.11.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 11/18/2016] [Accepted: 11/21/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To compare newly diagnosed localized prostate cancer patients who did and did not view a decision aid (DA) on their knowledge of the rationale for active surveillance (AS). METHODS A cross-sectional study was conducted among 452 newly diagnosed low-risk localized prostate cancer patients. Patients were mailed the video/DVD DA and completed a web-based questionnaire that contained two multiple choice questions assessing knowledge of the rationale for AS. Multivariable logistic regression was used to estimate the effect of the DA on knowledge of the rationale for AS. RESULTS Patients who watched the DA were more likely to correctly respond to each rationale for AS question; both comparisons were statistically significant. After adjustment, men who viewed the DA were 2.9 times as likely to correctly respond to both rationale for AS questions than men who did not view the DA (95% CI: 1.9-4.5). CONCLUSION Patients who viewed a DA better understand the reasons why AS is a viable treatment option for localized prostate cancer than patients who did not view a DA. PRACTICE IMPLICATIONS Urology clinics and practices should implement the utilization of a treatment DA for newly diagnosed, localized prostate cancer prior to the patients' first cancer consultation.
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Affiliation(s)
- Margaret K Formica
- Department of Public Health & Preventive Medicine, SUNY Upstate Medical University, Syracuse, USA; Department of Urology, SUNY Upstate Medical University, Syracuse, USA.
| | - Shaun Wason
- Section of Urology, Geisel School of Medicine at Dartmouth, Lebanon, USA; Urology of Virginia, Eastern Virginia Medical School, Virginia Beach, USA
| | - John D Seigne
- Section of Urology, Geisel School of Medicine at Dartmouth, Lebanon, USA
| | - Telisa M Stewart
- Department of Public Health & Preventive Medicine, SUNY Upstate Medical University, Syracuse, USA; Department of Urology, SUNY Upstate Medical University, Syracuse, USA; Section of Urology, Geisel School of Medicine at Dartmouth, Lebanon, USA
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3
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Venderbos LDF, Roobol MJ, Bangma CH, van den Bergh RCN, Bokhorst LP, Nieboer D, Godtman R, Hugosson J, van der Kwast T, Steyerberg EW. Rule-based versus probabilistic selection for active surveillance using three definitions of insignificant prostate cancer. World J Urol 2015; 34:253-60. [PMID: 26160006 PMCID: PMC4729867 DOI: 10.1007/s00345-015-1628-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 06/22/2015] [Indexed: 12/19/2022] Open
Abstract
PURPOSE To study whether probabilistic selection by the use of a nomogram could improve patient selection for active surveillance (AS) compared to the various sets of rule-based AS inclusion criteria currently used. METHODS We studied Dutch and Swedish patients participating in the European Randomized study of Screening for Prostate Cancer (ERSPC). We explored which men who were initially diagnosed with cT1-2, Gleason 6 (Gleason pattern ≤3 + 3) had histopathological indolent PCa at RP [defined as pT2, Gleason pattern ≤3 and tumour volume (TV) ≤0.5 or TV ≤ 1.3 ml, and TV no part of criteria (NoTV)]. Rule-based selection was according to the Prostate cancer Research International: Active Surveillance (PRIAS), Klotz, and Johns Hopkins criteria. An existing nomogram to define probability-based selection for AS was refitted for the TV1.3 and NoTV indolent PCa definitions. RESULTS 619 of 864 men undergoing RP had cT1-2, Gleason 6 disease at diagnosis and were analysed. Median follow-up was 8.9 years. 229 (37%), 356 (58%), and 410 (66%) fulfilled the TV0.5, TV1.3, and NoTV indolent PCa criteria at RP. Discriminating between indolent and significant disease according to area under the curve (AUC) was: TV0.5: 0.658 (PRIAS), 0.523 (Klotz), 0.642 (Hopkins), 0.685 (nomogram). TV1.3: 0.630 (PRIAS), 0.550 (Klotz), 0.615 (Hopkins), 0.646 (nomogram). NoTV: 0.603 (PRIAS), 0.530 (Klotz), 0.589 (Hopkins), 0.608 (nomogram). CONCLUSIONS The performance of a nomogram, the Johns Hopkins, and PRIAS rule-based criteria are comparable. Because the nomogram allows individual trade-offs, it could be a good alternative to rigid rule-based criteria.
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Affiliation(s)
- Lionne D F Venderbos
- Department of Urology, Erasmus University Medical Center, Room Na1710, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands. .,Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.
| | - Monique J Roobol
- Department of Urology, Erasmus University Medical Center, Room Na1710, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Chris H Bangma
- Department of Urology, Erasmus University Medical Center, Room Na1710, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Roderick C N van den Bergh
- Department of Urology, Erasmus University Medical Center, Room Na1710, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Leonard P Bokhorst
- Department of Urology, Erasmus University Medical Center, Room Na1710, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Daan Nieboer
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Rebecka Godtman
- Department of Urology, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden
| | - Jonas Hugosson
- Department of Urology, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden
| | - Theodorus van der Kwast
- Department of Pathology, Toronto General Hospital, University Health Network, Toronto, Canada
| | - Ewout W Steyerberg
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
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Parker PA, Davis JW, Latini DM, Baum G, Wang X, Ward JF, Kuban D, Frank SJ, Lee AK, Logothetis CJ, Kim J. Relationship between illness uncertainty, anxiety, fear of progression and quality of life in men with favourable-risk prostate cancer undergoing active surveillance. BJU Int 2015; 117:469-77. [PMID: 25714186 DOI: 10.1111/bju.13099] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVES To evaluate prospectively the associations between illness uncertainty, anxiety, fear of progression and general and disease-specific quality of life (QoL) in men with favourable-risk prostate cancer undergoing active surveillance (AS). PATIENTS AND METHODS After meeting stringent enrollment criteria for an AS cohort study at a single tertiary care cancer centre, 180 men with favourable-risk prostate cancer completed questionnaires at the time of enrollment and every 6 months for up to 30 months. Questionnaires assessed illness uncertainty, anxiety, prostate-specific QoL (using the Expanded Prostate Cancer Index Composite [EPIC] scale) and general QoL (using the 12-time short-form health survey [SF-12]) and fear of progression. We used linear mixed-model analyses and multilevel mediation analyses. RESULTS Sexual scores on the EPIC scale significantly declined over time (P < 0.05). Illness uncertainty was a significant predictor of all EPIC summary scores, SF-12 physical component summary (PCS) scores, mental component summary (MCS) scores and fear of progression scores (all P < 0.05), after controlling for demographic and clinicopathological factors. Anxiety predicted all EPIC summary, MCS and fear of progression scores (all P < 0.05) but not PCS scores (P = 0.08). Scores on PCS, MCS, EPIC summary scales (except sexual scale), and fear of progression did not change significantly over the study period (all P > 0.10). CONCLUSION Over the 2.5-year follow-up, QoL remained stable; only sexual function scores significantly declined. Illness uncertainty and anxiety were significant predictors of general and prostate-specific QoL and fear of progression. Interventions to reduce uncertainty and anxiety may enhance QoL for men with prostate cancer on AS.
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Affiliation(s)
| | - John W Davis
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - David M Latini
- Baylor College of Medicine and Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
| | - George Baum
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Xuemei Wang
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - John F Ward
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Deborah Kuban
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Steven J Frank
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Andrew K Lee
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Jeri Kim
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Dianat SS, Carter HB, Pienta KJ, Schaeffer EM, Landis PK, Epstein JI, Trock BJ, Macura KJ. Magnetic resonance-invisible versus magnetic resonance-visible prostate cancer in active surveillance: a preliminary report on disease outcomes. Urology 2014; 85:147-53. [PMID: 25440986 DOI: 10.1016/j.urology.2014.06.085] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Revised: 05/31/2014] [Accepted: 06/24/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess the association between magnetic resonance (MR) appearance of prostate cancer on a baseline multiparametric prostate (MP) MR imaging (MRI) and biopsy outcome in men with favorable-risk prostate cancer managed with active surveillance (AS). MATERIALS AND METHODS Ninety-six consecutive men (mean age, 67.8 years) who had a baseline MP MRI within 1 year of AS enrollment were included in the study. MP MRI results were analyzed to identify men with MR-invisible tumor defined as no signal abnormality on T2-weighted images, no focal restricted diffusion, and no perfusion abnormality on dynamic contrast-enhanced images. Patients with (n = 84) or without (n = 12) MR-visible tumor were compared and the impact of MR-invisibility of tumor on the risk of adverse biopsy pathology based on the Epstein criteria was investigated with a median follow-up of 23 months. RESULTS Adverse biopsy pathology occurred in 36.5% (35 of 96) of patients. There was no significant difference in the fulfillment of AS criteria at enrollment, prostate-specific antigen level or density, prostate volume, and number of biopsies (total or after MRI) between the 2 groups of patients. A total of 8.3% (1 of 12) of men with MR-invisible tumor had adverse biopsy pathology as compared with 40.5% (34 of 84) of men with MR-visible tumors. The MR-invisibility of tumor was associated with a lower risk of adverse biopsy pathology (crude relative risk = 0.35; 95% confidence interval, 0.10-1.25; prostate-specific antigen density-adjusted relative risk = 0.21; 95% confidence interval, 0.03-1.32). CONCLUSION The MR-invisibility of tumor on MP MRI could be of prognostic significance in monitoring men in AS with potential benefit of tailoring the frequency of surveillance biopsies and reducing the number of unnecessary biopsies.
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Affiliation(s)
- Seyed Saeid Dianat
- Russell H. Morgan Department of Radiology, Johns Hopkins Medical Institutions, Baltimore, MD
| | - H Ballentine Carter
- James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD
| | - Kenneth J Pienta
- James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD
| | - Edward M Schaeffer
- James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD
| | - Patricia K Landis
- James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD
| | - Jonathan I Epstein
- James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD; Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD
| | - Bruce J Trock
- James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD
| | - Katarzyna J Macura
- Russell H. Morgan Department of Radiology, Johns Hopkins Medical Institutions, Baltimore, MD; James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD.
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Welty CJ, Cowan JE, Nguyen H, Shinohara K, Perez N, Greene KL, Chan JM, Meng MV, Simko JP, Cooperberg MR, Carroll PR. Extended followup and risk factors for disease reclassification in a large active surveillance cohort for localized prostate cancer. J Urol 2014; 193:807-11. [PMID: 25261803 DOI: 10.1016/j.juro.2014.09.094] [Citation(s) in RCA: 119] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2014] [Indexed: 11/30/2022]
Abstract
PURPOSE Active surveillance to manage prostate cancer provides an alternative to immediate treatment in men with low risk prostate cancer. We report updated outcomes from a long-standing active surveillance cohort and factors associated with reclassification. MATERIALS AND METHODS We retrospectively reviewed data on all men enrolled in the active surveillance cohort at our institution with at least 6 months of followup between 1990 and 2013. Surveillance consisted of quarterly prostate specific antigen testing, repeat imaging with transrectal ultrasound at provider discretion and periodic repeat prostate biopsies. Factors associated with repeat biopsy reclassification and local treatment were determined by multivariate Cox proportional hazards regression. We also analyzed the association of prostate specific antigen density and outcomes stratified by prostate size. RESULTS A total of 810 men who consented to participate in the research cohort were followed on active surveillance for a median of 60 months. Of these men 556 (69%) met strict criteria for active surveillance. Five-year overall survival was 98%, treatment-free survival was 60% and biopsy reclassification-free survival was 40%. There were no prostate cancer related deaths. On multivariate analysis prostate specific antigen density was positively associated with the risk of biopsy reclassification and treatment while the number of biopsies and time between biopsies were inversely associated with the 2 outcomes (each p <0.01). When stratified by prostate volume, prostate specific antigen density remained significantly associated with biopsy reclassification for all strata but prostate specific antigen density was only significantly associated with treatment in men with a smaller prostate. CONCLUSIONS Significant prostate cancer related morbidity and mortality remained rare at intermediate followup. Prostate specific antigen density was independently associated with biopsy reclassification and treatment while on active surveillance.
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Affiliation(s)
- Christopher J Welty
- Department of Urology, University of California-San Francisco Helen Diller Family Comprehensive Cancer Center, University of California-San Francisco, San Francisco, California.
| | - Janet E Cowan
- Department of Urology, University of California-San Francisco Helen Diller Family Comprehensive Cancer Center, University of California-San Francisco, San Francisco, California
| | - Hao Nguyen
- Department of Urology, University of California-San Francisco Helen Diller Family Comprehensive Cancer Center, University of California-San Francisco, San Francisco, California
| | - Katsuto Shinohara
- Department of Urology, University of California-San Francisco Helen Diller Family Comprehensive Cancer Center, University of California-San Francisco, San Francisco, California
| | - Nannette Perez
- Department of Urology, University of California-San Francisco Helen Diller Family Comprehensive Cancer Center, University of California-San Francisco, San Francisco, California
| | - Kirsten L Greene
- Department of Urology, University of California-San Francisco Helen Diller Family Comprehensive Cancer Center, University of California-San Francisco, San Francisco, California
| | - June M Chan
- Department of Urology, University of California-San Francisco Helen Diller Family Comprehensive Cancer Center, University of California-San Francisco, San Francisco, California
| | - Maxwell V Meng
- Department of Urology, University of California-San Francisco Helen Diller Family Comprehensive Cancer Center, University of California-San Francisco, San Francisco, California
| | - Jeffry P Simko
- Department of Urology, University of California-San Francisco Helen Diller Family Comprehensive Cancer Center, University of California-San Francisco, San Francisco, California
| | - Matthew R Cooperberg
- Department of Urology, University of California-San Francisco Helen Diller Family Comprehensive Cancer Center, University of California-San Francisco, San Francisco, California
| | - Peter R Carroll
- Department of Urology, University of California-San Francisco Helen Diller Family Comprehensive Cancer Center, University of California-San Francisco, San Francisco, California
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Fillmore RA, Kojima C, Johnson C, Kolcun G, Dangott LJ, Zimmer WE. New concepts concerning prostate cancer screening. Exp Biol Med (Maywood) 2014; 239:793-804. [PMID: 24928864 DOI: 10.1177/1535370214539091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Prostate Cancer (CaP) is rapidly becoming a worldwide health issue. While CaP mortality has decreased in recent years, coincident with the widespread use of Prostate-Specific Antigen (PSA) screening, it remains the most common solid tumor in men and is the second leading cause of cancer death in the United States. The frequency of CaP is growing not only in western cultures, but also its incidence is dramatically increasing in eastern nations. Recently, examination of data from long-term trials and follow up has cast a shadow on the effectiveness of employing PSA as a primary screening tool for CaP. In this review, we not only summarize opinions from this examination and synthesize recommendations from several groups that suggest strategies for utilizing PSA as a tool, but also call for research into biomarkers for CaP diagnosis and disease progression. We also describe our recent work that identified a smooth muscle contractile protein in prostate epithelia, namely smooth muscle gamma actin, and indicate the potential for this molecule as a new unique footprint and as a CaP marker.
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Affiliation(s)
- Rebecca A Fillmore
- Department of Biological Sciences, University of Southern Mississippi Gulf Coast, Long Beach MS 39560, USA
| | - Chinatsu Kojima
- Department of Medical Physiology, College of Medicine, Texas A&M Health Science Center, Texas A&M University, College Station, TX 77843-1114, USA
| | - Chevaun Johnson
- Department of Medical Physiology, College of Medicine, Texas A&M Health Science Center, Texas A&M University, College Station, TX 77843-1114, USA
| | - Georgina Kolcun
- Department of Medical Physiology, College of Medicine, Texas A&M Health Science Center, Texas A&M University, College Station, TX 77843-1114, USA
| | - Lawrence J Dangott
- Department of Biochemistry and Biophysics, College of Agriculture and Life Sciences, Texas A&M University, College of Medicine, TX 77843, USA
| | - Warren E Zimmer
- Department of Medical Physiology, College of Medicine, Texas A&M Health Science Center, Texas A&M University, College Station, TX 77843-1114, USA Interdisciplinary Faculty of Toxicology, Texas A&M University, College Station, Texas, 77843 Faculty of Genetics, Texas A&M University, College Station, TX 77843, USA
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Bokhorst LP, Bangma CH, van Leenders GJ, Lous JJ, Moss SM, Schröder FH, Roobol MJ. Prostate-specific Antigen–Based Prostate Cancer Screening: Reduction of Prostate Cancer Mortality After Correction for Nonattendance and Contamination in the Rotterdam Section of the European Randomized Study of Screening for Prostate Cancer. Eur Urol 2014; 65:329-36. [DOI: 10.1016/j.eururo.2013.08.005] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Accepted: 08/01/2013] [Indexed: 10/26/2022]
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