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• W2798049832 abstract "Nuestro objetivo principal es describir la utilización actual en España de la vigilancia activa (VA) identificando áreas de potencial mejora. Un cuestionario generado en AEU/PIEM/2014/0001 (NCT02865330) fue remitido a todos los investigadores asociados (IA) durante los meses de enero-marzo del 2016. Incluía 7 dominios diferentes cubriendo diferentes aspectos en VA. Treinta y tres de cuarenta y un IA respondieron el cuestionario. La VA es principalmente controlada por los Servicios de Urología (87,9%). Hubo una gran heterogeneidad en las clásicas variables clínico-patológicas como criterios de selección. La densidad de antígeno prostático específico (PSAd) solo se usaba en el 36,4% IA. La RMmp era claramente infrautilizada como estadificación inicial (6%). Solo el 27,3% reconocía un alto nivel de experiencia en RMmp de sus colegas radiólogos. Con relación a la biopsia de confirmación, la mayoría de los centros utilizaban la vía transrectal y solo 2/33 la vía transperineal/software de fusión. La mitad de los IA entrevistados pasaron a tratamiento activo ante progresión patológica a Gleason 7 (3 + 4). No existió consenso en cuanto a cuándo pasar a estrategia de observación. El estudio demostró la infrautilización del consentimiento informado y de los cuestionarios de calidad de vida. El PSAd no se incluía como elemento decisor en la estrategia inicial en la mayoría. Se plasmó una desconfianza en la experiencia de los urólogos con la RMmp y una infrautilización de la vía transperineal, así como la no existencia de consenso en los protocolos de seguimiento y en los criterios de tratamiento activo., confirmando la necesidad de estudios prospectivos analizando el papel de la RMmp y los biomarcadores. Our main objective was to report the current use of active surveillance in Spain and to identify areas for potential improvement. A questionnaire generated by the Platform for Multicentre Studies of the Spanish Urology Association (AEU/PIEM/2014/0001, NCT02865330) was sent to all associate researchers from January to March 2016. The questionnaire included 7 domains covering various aspects of active surveillance. Thirty-three of the 41 associate researchers responded to the questionnaire. Active surveillance is mainly controlled by the urology departments (87.9%). There was considerable heterogeneity in the classical clinical-pathological variables as selection criteria. Only 36.4% of the associate researchers used prostate-specific antigen density (PSAd). Multiparametric magnetic resonance imaging (mpMRI) was clearly underused as initial staging (6%). Only 27.3% of the researchers stated that their radiology colleagues had a high level of experience in mpMRI. In terms of the confirmation biopsy, most of the centres used the transrectal pathway, and only 2 out of 33 used the transperineal pathway or fusion software. Half of the researchers interviewed applied active treatment when faced with disease progression to Gleason 7 (3+4). There was no consensus on when to transition to an observation strategy. The study showed the underutilisation of informed consent and quality-of-life questionnaires. PSAd was not included as a decisive element in the initial strategy for most researchers. There was a lack of confidence in the urologists’ mpMRI experience and an underutilisation of the transperineal pathway. There was also no consensus on the follow-up protocols and active treatment criteria, confirming the need for prospective studies to analyse the role of mpMRI and biomarkers." @default.
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• W2798049832 date "2018-09-01" @default.
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• W2798049832 title "Variabilidad dentro del Registro Nacional multicéntrico en Vigilancia Activa; cuestionario a urólogos" @default.
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• W2798049832 doi "https://doi.org/10.1016/j.acuro.2018.01.007" @default.
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