1
|
Vernooij RW, Lancee M, Cleves A, Dahm P, Bangma CH, Aben KK. Radical prostatectomy versus deferred treatment for localised prostate cancer. Cochrane Database Syst Rev 2020; 6:CD006590. [PMID: 32495338 PMCID: PMC7270852 DOI: 10.1002/14651858.cd006590.pub3] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Prostate cancer is a common cancer but is oftentimes slow growing. When confined to the prostate, radical prostatectomy (RP), which involves removal of the prostate, offers potential cure that may come at the price of adverse events. Deferred treatment, involving observation and palliative treatment only (watchful waiting (WW)) or close monitoring and delayed local treatment with curative intent as needed in the setting of disease progression (active monitoring (AM)/surveillance (AS)) might be an alternative. This is an update of a Cochrane Review previously published in 2010. OBJECTIVES To assess effects of RP compared with deferred treatment for clinically localised prostate cancer. SEARCH METHODS We searched the Cochrane Library (including CDSR, CENTRAL, DARE, and HTA), MEDLINE, Embase, AMED, Web of Science, LILACS, Scopus, and OpenGrey. Additionally, we searched two trial registries and conference abstracts of three conferences (EAU, AUA, and ASCO) until 3 March 2020. SELECTION CRITERIA We included all randomised controlled trials (RCTs) that compared RP versus deferred treatment in patients with localised prostate cancer, defined as T1-2, N0, M0 prostate cancer. DATA COLLECTION AND ANALYSIS Two review authors independently assessed the eligibility of references and extracted data from included studies. The primary outcome was time to death from any cause; secondary outcomes were: time to death from prostate cancer; time to disease progression; time to metastatic disease; quality of life, including urinary and sexual function; and adverse events. We assessed the certainty of evidence per outcome using the GRADE approach. MAIN RESULTS: We included four studies with 2635 participants (average age between 60 to 70 years). Three multicentre RCTs, from Europe and USA, compared RP with WW (n = 1537), and one compared RP with AM (n = 1098). Radical prostatectomy versus watchful waiting RP probably reduces the risk of death from any cause (hazard ratio (HR) 0.79, 95% confidence interval (CI) 0.70-0.90; 3 studies with 1537 participants; moderate-certainty evidence). Based on overall mortality at 29 years, this corresponds to 764 deaths per 1000 men in the RP group compared to 839 deaths per 1000 men in the WW group. RP probably also lowers the risk of death from prostate cancer (HR 0.57, 95% CI 0.44-0.73; 2 studies with 1426 participants; moderate-certainty evidence). Based on prostate cancer-specific mortality at 29 years, this corresponds to 195 deaths from prostate cancer per 1000 men in the RP group compared with 316 deaths from prostate cancer per 1000 men in the WW group. RP may reduce the risk of progression (HR 0.43, 95% CI 0.35-0.54; 2 studies with 1426 participants; I² = 54%; low-certainty evidence); at 19.5 years, this corresponds to 391 progressions per 1000 men for the RP group compared with 684 progressions per 1000 men for the WW group) and probably reduces the risk of developing metastatic disease (HR 0.56, 95% CI 0.46-0.70; 2 studies with 1426 participants; I² = 0%; moderate-certainty evidence); at 29 years, this corresponds to 271 metastatic diseases per 1000 men for RP compared with 431 metastatic diseases per 1000 men for WW. General quality of life at 12 years' follow-up is probably similar for both groups (risk ratio (RR) 1.0, 95% CI 0.85-1.16; low-certainty evidence), corresponding to 344 patients with high quality of life per 1000 men for the RP group compared with 344 patients with high quality of life per 1000 men for the WW group. Rates of urinary incontinence may be considerably higher (RR 3.97, 95% CI 2.34-6.74; low-certainty evidence), corresponding to 173 incontinent men per 1000 in the RP group compared with 44 incontinent men per 1000 in the WW group, as are rates of erectile dysfunction (RR 2.67, 95% CI 1.63-4.38; low-certainty evidence), corresponding to 389 erectile dysfunction events per 1000 for the RP group compared with 146 erectile dysfunction events per 1000 for the WW group, both at 10 years' follow-up. Radical prostatectomy versus active monitoring Based on one study including 1098 participants with 10 years' follow-up, there are probably no differences between RP and AM in time to death from any cause (HR 0.93, 95% CI 0.65-1.33; moderate-certainty evidence). Based on overall mortality at 10 years, this corresponds to 101 deaths per 1000 men in the RP group compared with 108 deaths per 1000 men in the AM group. Similarly, risk of death from prostate cancer probably is not different between the two groups (HR 0.63, 95% CI 0.21-1.89; moderate-certainty evidence). Based on prostate cancer-specific mortality at 10 years, this corresponds to nine prostate cancer deaths per 1000 men in the RP group compared with 15 prostate cancer deaths per 1000 men in the AM group. RP probably reduces the risk of progression (HR 0.39, 95% CI 0.27-0.56; moderate-certainty evidence; at 10 years, this corresponds to 86 progressions per 1000 men for RP compared with 206 progressions per 1000 men for AM) and the risk of developing metastatic disease (RR 0.39, 95% CI 0.21-0.73; moderate-certainty evidence; at 10 years, this corresponds to 24 metastatic diseases per 1000 men for the RP group compared with 61 metastatic diseases per 1000 men for the AM group).The general quality of life during follow-up was not different between the treatment groups. However, urinary function (mean difference (MD) 8.60 points lower, 95% CI 11.2-6.0 lower) and sexual function (MD 14.9 points lower, 95% CI 18.5-11.3 lower) on the Expanded Prostate Cancer Index Composite-26 (EPIC-26) instrument, were worse in the RP group. AUTHORS' CONCLUSIONS Based on long-term follow-up, RP compared with WW probably results in substantially improved oncological outcomes in men with localised prostate cancer but also markedly increases rates of urinary incontinence and erectile dysfunction. These findings are largely based on men diagnosed before widespread PSA screening, thereby limiting generalisability. Compared to AM, based on follow-up to 10 years, RP probably has similar outcomes with regard to overall and disease-specific survival yet probably reduces the risks of disease progression and metastatic disease. Urinary function and sexual function are probably decreased for the patients treated with RP.
Collapse
Affiliation(s)
- Robin Wm Vernooij
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, Netherlands
| | - Michelle Lancee
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, Netherlands
| | - Anne Cleves
- Velindre NHS Trust, Cardiff University Library Services, Cardiff, UK
| | - Philipp Dahm
- Urology Section, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
- Department of Urology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Chris H Bangma
- Department of Urology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Katja Kh Aben
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, Netherlands
| |
Collapse
|
2
|
Radical Prostatectomy or Observation for Clinically Localized Prostate Cancer: Extended Follow-up of the Prostate Cancer Intervention Versus Observation Trial (PIVOT). Eur Urol 2020; 77:713-724. [DOI: 10.1016/j.eururo.2020.02.009] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 02/11/2020] [Indexed: 11/18/2022]
|
3
|
Bright CJ, Brentnall AR, Wooldrage K, Myles J, Sasieni P, Duffy SW. Errors in determination of net survival: cause-specific and relative survival settings. Br J Cancer 2020; 122:1094-1101. [PMID: 32037401 PMCID: PMC7109046 DOI: 10.1038/s41416-020-0739-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 01/07/2020] [Accepted: 01/17/2020] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Cause-specific and relative survival estimates differ. We aimed to examine these differences in common cancers where by possible identifying the most plausible sources of error in each estimate. METHODS Ten-year cause-specific and relative survival were estimated for lung, breast, prostate, ovary, oesophagus and colorectal cancers. The cause-specific survival was corrected for misclassification of cause of death. The Pohar-Perme relative survival estimator was modified by (1) correcting for differences in deaths from ischaemic heart disease (IHD) between cancers and general population; or (2) correcting the population hazard for smoking (lung cancer only). RESULTS For all cancers except breast and prostate, relative survival was lower than cause-specific. Correction for published error rates in cause of death gave implausible results. Correction for rates of IHD death gave slightly different relative survival estimates for lung, oesophagus and colorectal cancers. For lung cancer, when the population hazard was inflated for smoking, survival estimates were increased. CONCLUSION Results agreed with the consensus that relative survival is usually preferable. However, for some cancers, relative survival might be inaccurate (e.g. lung and prostate). Likely solutions include enhancing life tables to include other demographic variables than age and sex, and to stratify relative survival calculation by cause of death.
Collapse
Affiliation(s)
- Chloe J Bright
- National Cancer Registration and Analysis Service, Public Health England, London, UK.
| | - Adam R Brentnall
- Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Kate Wooldrage
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Jonathon Myles
- Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Peter Sasieni
- School of Cancer and Pharmaceutical Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Stephen W Duffy
- Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| |
Collapse
|
4
|
Löffeler S, Halland A, Weedon-Fekjær H, Nikitenko A, Ellingsen CL, Haug ES. High Norwegian prostate cancer mortality: evidence of over-reporting. Scand J Urol 2018; 52:122-128. [DOI: 10.1080/21681805.2017.1421260] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Sven Löffeler
- Department of Urology, Sykehuset I Vestfold (Vestfold Hospital Trust), Halfdan Wilhelmsens Allé, Tønsberg, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Adrian Halland
- Department of Urology, Sykehuset I Vestfold (Vestfold Hospital Trust), Halfdan Wilhelmsens Allé, Tønsberg, Norway
| | - Harald Weedon-Fekjær
- Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Anastasia Nikitenko
- Department of Oncology, Sykehuset I Vestfold (Vestfold Hospital Trust), Halfdan Wilhelmsens Allé, Tønsberg, Norway
| | - Christian Lycke Ellingsen
- Cause of Death Registry, Health Data and Digitalisation, Norwegian Institute of Public Health, Bergen, Norway
| | - Erik Skaaheim Haug
- Department of Urology, Sykehuset I Vestfold (Vestfold Hospital Trust), Halfdan Wilhelmsens Allé, Tønsberg, Norway
| |
Collapse
|
5
|
Packiam VT, Eggener SE. Minimal difference in survival between radical prostatectomy and observation in men with modest life expectancy. EVIDENCE-BASED MEDICINE 2017; 22:222. [PMID: 29127213 DOI: 10.1136/ebmed-2017-110837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/02/2017] [Indexed: 06/07/2023]
Affiliation(s)
- Vignesh T Packiam
- Department of Surgery, Section of Urology, The University of Chicago Medicine, Chicago, Illinois, USA
| | - Scott E Eggener
- Department of Surgery, Section of Urology, The University of Chicago Medicine, Chicago, Illinois, USA
| |
Collapse
|
6
|
Wilt TJ, Jones KM, Barry MJ, Andriole GL, Culkin D, Wheeler T, Aronson WJ, Brawer MK. Follow-up of Prostatectomy versus Observation for Early Prostate Cancer. N Engl J Med 2017; 377:132-142. [PMID: 28700844 DOI: 10.1056/nejmoa1615869] [Citation(s) in RCA: 364] [Impact Index Per Article: 52.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND We previously found no significant differences in mortality between men who underwent surgery for localized prostate cancer and those who were treated with observation only. Uncertainty persists regarding nonfatal health outcomes and long-term mortality. METHODS From November 1994 through January 2002, we randomly assigned 731 men with localized prostate cancer to radical prostatectomy or observation. We extended follow-up through August 2014 for our primary outcome, all-cause mortality, and the main secondary outcome, prostate-cancer mortality. We describe disease progression, treatments received, and patient-reported outcomes through January 2010 (original follow-up). RESULTS During 19.5 years of follow-up (median, 12.7 years), death occurred in 223 of 364 men (61.3%) assigned to surgery and in 245 of 367 (66.8%) assigned to observation (absolute difference in risk, 5.5 percentage points; 95% confidence interval [CI], -1.5 to 12.4; hazard ratio, 0.84; 95% CI, 0.70 to 1.01; P=0.06). Death attributed to prostate cancer or treatment occurred in 27 men (7.4%) assigned to surgery and in 42 men (11.4%) assigned to observation (absolute difference in risk, 4.0 percentage points; 95% CI, -0.2 to 8.3; hazard ratio, 0.63; 95% CI, 0.39 to 1.02; P=0.06). Surgery may have been associated with lower all-cause mortality than observation among men with intermediate-risk disease (absolute difference, 14.5 percentage points; 95% CI, 2.8 to 25.6) but not among those with low-risk disease (absolute difference, 0.7 percentage points; 95% CI, -10.5 to 11.8) or high-risk disease (absolute difference, 2.3 percentage points; 95% CI, -11.5 to 16.1) (P=0.08 for interaction). Treatment for disease progression was less frequent with surgery than with observation (absolute difference, 26.2 percentage points; 95% CI, 19.0 to 32.9); treatment was primarily for asymptomatic, local, or biochemical (prostate-specific antigen) progression. Urinary incontinence and erectile and sexual dysfunction were each greater with surgery than with observation through 10 years. Disease-related or treatment-related limitations in activities of daily living were greater with surgery than with observation through 2 years. CONCLUSIONS After nearly 20 years of follow-up among men with localized prostate cancer, surgery was not associated with significantly lower all-cause or prostate-cancer mortality than observation. Surgery was associated with a higher frequency of adverse events than observation but a lower frequency of treatment for disease progression, mostly for asymptomatic, local, or biochemical progression. (Funded by the Department of Veterans Affairs and others; PIVOT ClinicalTrials.gov number, NCT00007644 .).
Collapse
Affiliation(s)
- Timothy J Wilt
- From the Minneapolis Veterans Affairs (VA) Health Care System and Center for Chronic Disease Outcomes Research and the Section of General Medicine, University of Minnesota School of Medicine, Minneapolis (T.J.W.); the VA Cooperative Studies Program Coordinating Center, Perry Point, MD (K.M.J.); the General Medicine Division, Massachusetts General Hospital, Boston (M.J.B.); the Division of Urology, Washington University School of Medicine, St. Louis (G.L.A.); the Department of Urology, University of Oklahoma College of Medicine, Oklahoma City (D.C.); the Department of Pathology and Immunology, Baylor College of Medicine, Houston (T.W.); VA Medical Center, Greater Los Angeles Healthcare System, Los Angeles (W.J.A.); and Myriad Genetics Laboratories, Salt Lake City (M.K.B.)
| | - Karen M Jones
- From the Minneapolis Veterans Affairs (VA) Health Care System and Center for Chronic Disease Outcomes Research and the Section of General Medicine, University of Minnesota School of Medicine, Minneapolis (T.J.W.); the VA Cooperative Studies Program Coordinating Center, Perry Point, MD (K.M.J.); the General Medicine Division, Massachusetts General Hospital, Boston (M.J.B.); the Division of Urology, Washington University School of Medicine, St. Louis (G.L.A.); the Department of Urology, University of Oklahoma College of Medicine, Oklahoma City (D.C.); the Department of Pathology and Immunology, Baylor College of Medicine, Houston (T.W.); VA Medical Center, Greater Los Angeles Healthcare System, Los Angeles (W.J.A.); and Myriad Genetics Laboratories, Salt Lake City (M.K.B.)
| | - Michael J Barry
- From the Minneapolis Veterans Affairs (VA) Health Care System and Center for Chronic Disease Outcomes Research and the Section of General Medicine, University of Minnesota School of Medicine, Minneapolis (T.J.W.); the VA Cooperative Studies Program Coordinating Center, Perry Point, MD (K.M.J.); the General Medicine Division, Massachusetts General Hospital, Boston (M.J.B.); the Division of Urology, Washington University School of Medicine, St. Louis (G.L.A.); the Department of Urology, University of Oklahoma College of Medicine, Oklahoma City (D.C.); the Department of Pathology and Immunology, Baylor College of Medicine, Houston (T.W.); VA Medical Center, Greater Los Angeles Healthcare System, Los Angeles (W.J.A.); and Myriad Genetics Laboratories, Salt Lake City (M.K.B.)
| | - Gerald L Andriole
- From the Minneapolis Veterans Affairs (VA) Health Care System and Center for Chronic Disease Outcomes Research and the Section of General Medicine, University of Minnesota School of Medicine, Minneapolis (T.J.W.); the VA Cooperative Studies Program Coordinating Center, Perry Point, MD (K.M.J.); the General Medicine Division, Massachusetts General Hospital, Boston (M.J.B.); the Division of Urology, Washington University School of Medicine, St. Louis (G.L.A.); the Department of Urology, University of Oklahoma College of Medicine, Oklahoma City (D.C.); the Department of Pathology and Immunology, Baylor College of Medicine, Houston (T.W.); VA Medical Center, Greater Los Angeles Healthcare System, Los Angeles (W.J.A.); and Myriad Genetics Laboratories, Salt Lake City (M.K.B.)
| | - Daniel Culkin
- From the Minneapolis Veterans Affairs (VA) Health Care System and Center for Chronic Disease Outcomes Research and the Section of General Medicine, University of Minnesota School of Medicine, Minneapolis (T.J.W.); the VA Cooperative Studies Program Coordinating Center, Perry Point, MD (K.M.J.); the General Medicine Division, Massachusetts General Hospital, Boston (M.J.B.); the Division of Urology, Washington University School of Medicine, St. Louis (G.L.A.); the Department of Urology, University of Oklahoma College of Medicine, Oklahoma City (D.C.); the Department of Pathology and Immunology, Baylor College of Medicine, Houston (T.W.); VA Medical Center, Greater Los Angeles Healthcare System, Los Angeles (W.J.A.); and Myriad Genetics Laboratories, Salt Lake City (M.K.B.)
| | - Thomas Wheeler
- From the Minneapolis Veterans Affairs (VA) Health Care System and Center for Chronic Disease Outcomes Research and the Section of General Medicine, University of Minnesota School of Medicine, Minneapolis (T.J.W.); the VA Cooperative Studies Program Coordinating Center, Perry Point, MD (K.M.J.); the General Medicine Division, Massachusetts General Hospital, Boston (M.J.B.); the Division of Urology, Washington University School of Medicine, St. Louis (G.L.A.); the Department of Urology, University of Oklahoma College of Medicine, Oklahoma City (D.C.); the Department of Pathology and Immunology, Baylor College of Medicine, Houston (T.W.); VA Medical Center, Greater Los Angeles Healthcare System, Los Angeles (W.J.A.); and Myriad Genetics Laboratories, Salt Lake City (M.K.B.)
| | - William J Aronson
- From the Minneapolis Veterans Affairs (VA) Health Care System and Center for Chronic Disease Outcomes Research and the Section of General Medicine, University of Minnesota School of Medicine, Minneapolis (T.J.W.); the VA Cooperative Studies Program Coordinating Center, Perry Point, MD (K.M.J.); the General Medicine Division, Massachusetts General Hospital, Boston (M.J.B.); the Division of Urology, Washington University School of Medicine, St. Louis (G.L.A.); the Department of Urology, University of Oklahoma College of Medicine, Oklahoma City (D.C.); the Department of Pathology and Immunology, Baylor College of Medicine, Houston (T.W.); VA Medical Center, Greater Los Angeles Healthcare System, Los Angeles (W.J.A.); and Myriad Genetics Laboratories, Salt Lake City (M.K.B.)
| | - Michael K Brawer
- From the Minneapolis Veterans Affairs (VA) Health Care System and Center for Chronic Disease Outcomes Research and the Section of General Medicine, University of Minnesota School of Medicine, Minneapolis (T.J.W.); the VA Cooperative Studies Program Coordinating Center, Perry Point, MD (K.M.J.); the General Medicine Division, Massachusetts General Hospital, Boston (M.J.B.); the Division of Urology, Washington University School of Medicine, St. Louis (G.L.A.); the Department of Urology, University of Oklahoma College of Medicine, Oklahoma City (D.C.); the Department of Pathology and Immunology, Baylor College of Medicine, Houston (T.W.); VA Medical Center, Greater Los Angeles Healthcare System, Los Angeles (W.J.A.); and Myriad Genetics Laboratories, Salt Lake City (M.K.B.)
| |
Collapse
|
7
|
Ojerholm E, Smith A, Hwang WT, Baumann BC, Tucker KN, Lerner SP, Mamtani R, Boursi B, Christodouleas JP. Neutrophil-to-lymphocyte ratio as a bladder cancer biomarker: Assessing prognostic and predictive value in SWOG 8710. Cancer 2016; 123:794-801. [PMID: 27787873 DOI: 10.1002/cncr.30422] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 09/12/2016] [Accepted: 10/03/2016] [Indexed: 12/18/2022]
Abstract
BACKGROUND Risk stratification is a major challenge in bladder cancer (BC), and a biomarker is needed. Multiple studies have reported the neutrophil-to-lymphocyte ratio (NLR) as a promising candidate; however, these analyses have methodological limitations. Therefore, the authors performed a category B biomarker study to test whether NLR is prognostic for overall survival (OS) after curative treatment or is predictive for the survival benefit from neoadjuvant chemotherapy (NAC). METHODS This study is an unplanned secondary analysis of SWOG 8710, a randomized phase 3 trial that assessed cystectomy with or without NAC in 317 patients with muscle-invasive BC. NLR was calculated from prospectively collected complete blood counts. For the prognostic analysis, 230 patients were identified; for the predictive analysis, 263 were identified. NLR was evaluated with proportional hazards models including prespecified factors (age, sex, T-stage, lymphovascular invasion, and treatment arm). RESULTS With a median follow-up of 18.6 years, there were 172 and 205 deaths in the prognostic and predictive cohorts, respectively. In a multivariable analysis, NLR was not prognostic for OS (hazard ratio [HR], 1.04; 95% confidence interval [CI], 0.98-1.11; P = .24). Furthermore, NLR did not predict for the OS benefit from NAC (HR, 1.01; 95% CI, 0.90-1.14; P = .86). Factors associated with worse OS were older age (HR, 1.05; 95% CI, 1.04-1.07; P < .001) and surgery without NAC (HR, 1.39; 95% CI, 1.03-1.88; P = .03). CONCLUSIONS This is the first analysis of NLR in BC to use prospectively collected clinical trial data. In contrast to previous studies, it suggests that NLR is neither a prognostic nor predictive biomarker for OS in muscle-invasive BC. Cancer 2017;123:794-801. © 2016 American Cancer Society.
Collapse
Affiliation(s)
- Eric Ojerholm
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Andrew Smith
- Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Wei-Ting Hwang
- Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Brian C Baumann
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kai N Tucker
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Ronac Mamtani
- Medical Oncology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ben Boursi
- Medical Oncology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - John P Christodouleas
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania
| |
Collapse
|
8
|
Turner EL, Metcalfe C, Donovan JL, Noble S, Sterne JAC, Lane JA, I Walsh E, Hill EM, Down L, Ben-Shlomo Y, Oliver SE, Evans S, Brindle P, Williams NJ, Hughes LJ, Davies CF, Ng SY, Neal DE, Hamdy FC, Albertsen P, Reid CM, Oxley J, McFarlane J, Robinson MC, Adolfsson J, Zietman A, Baum M, Koupparis A, Martin RM. Contemporary accuracy of death certificates for coding prostate cancer as a cause of death: Is reliance on death certification good enough? A comparison with blinded review by an independent cause of death evaluation committee. Br J Cancer 2016; 115:90-4. [PMID: 27253172 PMCID: PMC4931376 DOI: 10.1038/bjc.2016.162] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 04/18/2016] [Accepted: 04/30/2016] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Accurate cause of death assignment is crucial for prostate cancer epidemiology and trials reporting prostate cancer-specific mortality outcomes. METHODS We compared death certificate information with independent cause of death evaluation by an expert committee within a prostate cancer trial (2002-2015). RESULTS Of 1236 deaths assessed, expert committee evaluation attributed 523 (42%) to prostate cancer, agreeing with death certificate cause of death in 1134 cases (92%, 95% CI: 90%, 93%). The sensitivity of death certificates in identifying prostate cancer deaths as classified by the committee was 91% (95% CI: 89%, 94%); specificity was 92% (95% CI: 90%, 94%). Sensitivity and specificity were lower where death occurred within 1 year of diagnosis, and where there was another primary cancer diagnosis. CONCLUSIONS UK death certificates accurately identify cause of death in men with prostate cancer, supporting their use in routine statistics. Possible differential misattribution by trial arm supports independent evaluation in randomised trials.
Collapse
Affiliation(s)
- Emma L Turner
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
| | - Chris Metcalfe
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
| | - Jenny L Donovan
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
| | - Sian Noble
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
| | - Jonathan A C Sterne
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
| | - J Athene Lane
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
| | - Eleanor I Walsh
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
| | - Elizabeth M Hill
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
| | - Liz Down
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
| | - Yoav Ben-Shlomo
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
| | - Steven E Oliver
- Department of Health Sciences, University of York and the Hull York Medical School, YO10 5DD, UK
| | - Simon Evans
- Urology Department, Royal United Hospital, Combe Park, Bath BA1 3NG, UK
| | - Peter Brindle
- Avon Primary Care Research Collaborative, South Plaza, Marlborough Street, Bristol BS1 3NX, UK
| | - Naomi J Williams
- School of Social and Community Medicine, University of Bristol, Royal Hallamshire Hospital, Sheffield S10 2JF, UK
| | - Laura J Hughes
- Department of Oncology, University of Cambridge, Addenbrooke's Hospital, Box 279 (S4), Cambridge CB2 0QQ, UK
| | - Charlotte F Davies
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
| | - Siaw Yein Ng
- School of Social and Community Medicine, University of Bristol, Freeman Hospital, High Heaton, Newcastle upon Tyne NE7 7DN, UK
| | - David E Neal
- Nuffield Department of Surgical Sciences, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - Freddie C Hamdy
- Nuffield Department of Surgical Sciences, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - Peter Albertsen
- University of Connecticut Health Center, Farmington, St Francis Hospital and Medical Center, Hartford, CT, USA
| | - Colette M Reid
- Department of Palliative Medicine, Bristol Haematology and Oncology Centre, Bristol BS2 8ED, UK
| | - Jon Oxley
- Department of Cellular Pathology, North Bristol NHS Trust, Southmead Hospital, Bristol BS10 5NB, UK
| | - John McFarlane
- Urology Department, Royal United Hospital, Combe Park, Bath BA1 3NG, UK
| | - Mary C Robinson
- Department of Cellular Pathology, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK
| | - Jan Adolfsson
- Department of Clinical Science, Karolinska Institutet, Stokholm, Sweden
| | - Anthony Zietman
- Harvard Radiation Oncology Program, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - Michael Baum
- Department of Surgery, University College London, Gower Street, London WC1E 6BT, UK
| | - Anthony Koupparis
- Department of Urology, North Bristol NHS Trust, Southmead Hospital, Bristol BS10 5NB, UK
| | - Richard M Martin
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
- School of Social and Community Medicine, MRC/University of Bristol Integrative Epidemiology Unit, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK
| |
Collapse
|
9
|
Versorgungsabbild zum Prostatakarzinom in DVPZ-Prostatazentren in Deutschland. Urologe A 2015; 54:1546, 1548-54. [DOI: 10.1007/s00120-015-3843-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
10
|
Wolff RF, Ryder S, Bossi A, Briganti A, Crook J, Henry A, Karnes J, Potters L, de Reijke T, Stone N, Burckhardt M, Duffy S, Worthy G, Kleijnen J. A systematic review of randomised controlled trials of radiotherapy for localised prostate cancer. Eur J Cancer 2015; 51:2345-67. [DOI: 10.1016/j.ejca.2015.07.019] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 07/06/2015] [Accepted: 07/16/2015] [Indexed: 12/30/2022]
|
11
|
Ashrafi D, Baade P, Yaxley J, Roberts MJ, Williams S, Gardiner RA. Long-term Survival Outcomes for Men Who Provided Ejaculate Specimens for Prostate Cancer Research: Implications for Patient Management. Eur Urol Focus 2015; 1:200-206. [PMID: 28723434 DOI: 10.1016/j.euf.2015.04.002] [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] [Received: 01/28/2015] [Revised: 03/18/2015] [Accepted: 04/03/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Determining whether men diagnosed with early prostate cancer (PCa) will live long enough to benefit from interventions with curative intent is difficult. Although validated instruments for predicting patient survival are available, these do not have clinical utility so are not used routinely in practice. OBJECTIVE To test the hypothesis that volunteers who provided ejaculate specimens had a high survival rate at 10 and 15 yr and beyond. DESIGN, SETTING, AND PARTICIPANTS A total of 290 patients investigated because of high serum prostate-specific antigen donated ejaculate specimens for research between January 1992 and May 2003. The median age at the time of ejaculation was 63.5 yr. 153 of the donors were diagnosed with PCa and followed up to December 31, 2013. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Survival outcomes were compared with those for the whole population, as indicated by life expectancy tables up to 20 yr. RESULTS AND LIMITATIONS Men in the PCa group had life expectancies comparable with values listed in life expectancy tables for the whole population. Overall, PCa-specific and relative survival were significantly better for men in the non-PCa and PCa groups in comparison with men diagnosed with PCa in Queensland during the same period. Relative survival for those aged 20-49, 50-64, and ≥65 yr was >100% for ejaculate donors and 81.5%, 82.7%, and 65.2%, respectively, for the Queensland Cancer Registry reference at 10 yr. These findings for this highly selected patient cohort support the hypothesis that an ability to provide an ejaculate specimen is associated with a high likelihood of surviving 10-20 yr after donation, whether or not PCa was detected. CONCLUSION Life expectancy tables may serve as a quick and simple life expectancy indicator for biopsy patients who donate ejaculate. PATIENT SUMMARY Life expectancy tables indicated survival of up to 20 yr for men who provided ejaculate specimens for prostate cancer research.
Collapse
Affiliation(s)
- Darius Ashrafi
- School of Medicine, University of Queensland, Brisbane, Australia; Centre for Clinical Research, University of Queensland, Brisbane, Australia
| | - Peter Baade
- Cancer Council Queensland, Brisbane, Australia; School of Public Health & Social Work, Queensland University of Technology, Brisbane, Australia; Griffith Health Institute, Griffith University, Brisbane, Australia
| | - John Yaxley
- Royal Brisbane & Women's Hospital, Brisbane, Australia
| | - Matthew J Roberts
- School of Medicine, University of Queensland, Brisbane, Australia; Centre for Clinical Research, University of Queensland, Brisbane, Australia
| | - Scott Williams
- Peter Macallum Cancer Centre, University of Melbourne, Melbourne, Australia
| | - Robert A Gardiner
- School of Medicine, University of Queensland, Brisbane, Australia; Centre for Clinical Research, University of Queensland, Brisbane, Australia; Royal Brisbane & Women's Hospital, Brisbane, Australia; Edith Cowan University, Perth, Australia.
| |
Collapse
|
12
|
Prasad SM, Hu JC. Reply to P. Stattin. J Clin Oncol 2015; 33:1087. [PMID: 25646193 DOI: 10.1200/jco.2014.59.3269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Jim C Hu
- University of California Los Angeles, Los Angeles, CA
| |
Collapse
|
13
|
Williams NJ, Hill EM, Ng SY, Martin RM, Metcalfe C, Donovan JL, Evans S, Hughes LJ, Davies CF, Hamdy FC, Neal DE, Turner EL. Standardisation of information submitted to an endpoint committee for cause of death assignment in a cancer screening trial – lessons learnt from CAP (Cluster randomised triAl of PSA testing for Prostate cancer). BMC Med Res Methodol 2015; 15:6. [PMID: 25613468 PMCID: PMC4429825 DOI: 10.1186/1471-2288-15-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 01/15/2015] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND In cancer screening trials where the primary outcome is target cancer-specific mortality, the unbiased determination of underlying cause of death (UCD) is crucial. To minimise bias, the UCD should be independently verified by expert reviewers, blinded to death certificate data and trial arm. We investigated whether standardising the information submitted for UCD assignment in a population-based randomised controlled trial of prostate-specific antigen (PSA) testing for prostate cancer reduced the reviewers' ability to correctly guess the trial arm. METHODS Over 550 General Practitioner (GP) practices (>415,000 men aged 50-69 years) were cluster-randomised to PSA testing (intervention arm) or the National Health Service (NHS) prostate cancer risk management programme (control arm) between 2001 and 2007. Assignment of UCD was by independent reviews of researcher-written clinical vignettes that masked trial arm and death certificate information. A period of time after the process began (the initial phase), we analysed whether the reviewers could correctly identify trial arm from the vignettes, and the reasons for their choice. This feedback led to further standardisation of information (second phase), after which we re-assessed the extent of correct identification of trial arm. RESULTS 1099 assessments of 509 vignettes were completed by January 2014. In the initial phase (n = 510 assessments), reviewers were unsure of trial arm in 33% of intervention and 30% of control arm assessments and were influenced by symptoms at diagnosis, PSA test result and study-specific criteria. In the second phase (n = 589), the respective proportions of uncertainty were 45% and 48%. The percentage of cases whereby reviewers were unable to determine the trial arm was greater following the standardisation of information provided in the vignettes. The chances of a correct guess and an incorrect guess were equalised in each arm, following further standardisation. CONCLUSIONS It is possible to mask trial arm from cause of death reviewers, by using their feedback to standardise the information submitted to them. TRIAL REGISTRATION ISRCTN92187251.
Collapse
Affiliation(s)
- Naomi J Williams
- School of Social and Community Medicine, University of Bristol, based at Royal Hallamshire Hospital, Sheffield, S10 2JF, UK.
| | - Elizabeth M Hill
- School of Social and Community Medicine, University of Bristol, Canynge Hall, Bristol, BS8 2PS, UK.
| | - Siaw Yein Ng
- School of Social and Community Medicine, University of Bristol, based at Freeman Hospital, High Heaton, Newcastle-upon-Tyne, NE7 7DN, UK.
| | - Richard M Martin
- School of Social and Community Medicine, University of Bristol, Canynge Hall, Bristol, BS8 2PS, UK.
| | - Chris Metcalfe
- School of Social and Community Medicine, University of Bristol, Canynge Hall, Bristol, BS8 2PS, UK.
| | - Jenny L Donovan
- School of Social and Community Medicine, University of Bristol, Canynge Hall, Bristol, BS8 2PS, UK.
| | | | - Laura J Hughes
- Department of Oncology, University of Cambridge, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK.
| | - Charlotte F Davies
- School of Social and Community Medicine, University of Bristol, Canynge Hall, Bristol, BS8 2PS, UK.
| | - Freddie C Hamdy
- Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital, Oxford, OX3 9DU, UK.
| | - David E Neal
- Department of Oncology, University of Cambridge, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK.
| | - Emma L Turner
- School of Social and Community Medicine, University of Bristol, Canynge Hall, Bristol, BS8 2PS, UK.
| |
Collapse
|