학술논문
Analysis of active surveillance uptake for localized prostate cancer in Quebec in 2016: A Canadian bicentric study and comparison with 2010 data.
Document Type
Academic Journal
Author
Dariane C; Institut du cancer de Montréal, centre de recherche du centre hospitalier de l'université de Montréal (CRCHUM), Montréal, Canada; Department of Urology, hôpital européen Georges-Pompidou, Paris University, 20, rue Leblanc, 75015 Paris, France. Electronic address: dariane.charles@gmail.com.; Chierigo F; Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy; Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Canada.; Ouellet V; Institut du cancer de Montréal, centre de recherche du centre hospitalier de l'université de Montréal (CRCHUM), Montréal, Canada.; Delvoye N; Institut du cancer de Montréal, centre de recherche du centre hospitalier de l'université de Montréal (CRCHUM), Montréal, Canada.; Jammal MP; Centre de santé et des services sociaux de Laval, Laval, QC, Canada.; Bégin LR; Centre intégré de santé et des services sociaux des Laurentides, St-Eustache, QC, Canada.; Paradis JB; Centre de santé et des services sociaux de Chicoutimi, Chicoutimi, QC, Canada.; Mes-Masson AM; Institut du cancer de Montréal, centre de recherche du centre hospitalier de l'université de Montréal (CRCHUM), Montréal, Canada.; Karakiewicz PI; Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Canada.; Saad F; Institut du cancer de Montréal, centre de recherche du centre hospitalier de l'université de Montréal (CRCHUM), Montréal, Canada; Department of Surgery, Division of Urology, centre hospitalier de l'université de Montréal (CHUM), Montréal, Canada.
Source
Publisher: Elsevier Masson SAS Country of Publication: France NLM ID: 9918752079106676 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2950-3930 (Electronic) Linking ISSN: 29503930 NLM ISO Abbreviation: Fr J Urol Subsets: MEDLINE
Subject
Language
English
Abstract
Introduction: Active surveillance (AS) has emerged as a primary management strategy for low-risk prostate cancer (PC) patients. We aimed to assess AS uptake over a 1-year snapshot throughout Quebec and to compare it to 2010 multicentric Canadian data.
Methods: A retrospective chart review and data collection was performed in 1 academic and 2 non-academic community centres from Quebec, among men identified in 2016 with localized T1c-T2c PC on biopsy, fulfilling NCCN criteria of low-risk (LR)-PC, including very-low-risk (VLR) and non-VLR-PC, and favourable-intermediate risk (FIR)-PC. AS adherence was defined when chosen as initial strategy, without any radical treatment within 6 months.
Results: Overall, 259 patients fulfilled the inclusion criteria with 50.2% of VLR-PC patients. At 6 months, 81% patients in the LR group and 65% in the FIR group were considered as adherent to AS, in both centres, but with an increased use of AS in the community centres compared to 2010 data. The rates of AS maintenance decreased at 12 months to respectively 69% and 58%. Among the VLR group, the rate of initiation was 98% and decreased to 85% at 12 months.
Conclusion: Our data suggest that the majority of low-risk PC patients indeed initiated an AS in 2016, with even a greater proportion of VLR-PC patients compared to 2010. This ideal strategy should be encouraged and improved at 12 months, and assessed with recent data and longer follow-up.
(Copyright © 2023 Elsevier Masson SAS. All rights reserved.)
Methods: A retrospective chart review and data collection was performed in 1 academic and 2 non-academic community centres from Quebec, among men identified in 2016 with localized T1c-T2c PC on biopsy, fulfilling NCCN criteria of low-risk (LR)-PC, including very-low-risk (VLR) and non-VLR-PC, and favourable-intermediate risk (FIR)-PC. AS adherence was defined when chosen as initial strategy, without any radical treatment within 6 months.
Results: Overall, 259 patients fulfilled the inclusion criteria with 50.2% of VLR-PC patients. At 6 months, 81% patients in the LR group and 65% in the FIR group were considered as adherent to AS, in both centres, but with an increased use of AS in the community centres compared to 2010 data. The rates of AS maintenance decreased at 12 months to respectively 69% and 58%. Among the VLR group, the rate of initiation was 98% and decreased to 85% at 12 months.
Conclusion: Our data suggest that the majority of low-risk PC patients indeed initiated an AS in 2016, with even a greater proportion of VLR-PC patients compared to 2010. This ideal strategy should be encouraged and improved at 12 months, and assessed with recent data and longer follow-up.
(Copyright © 2023 Elsevier Masson SAS. All rights reserved.)