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• W4322702010 abstract "No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Jul 2000PATTERNS OF TREATMENT OF PATIENTS WITH PROSTATE CANCER INITIALLY MANAGED WITH SURVEILLANCE: RESULTS FROM THE CaPSURE DATABASE THERESA M. KOPPIE, GARY D. GROSSFELD, DAVID MILLER, JENNY YU, DAVID STIER, JEANETTE M. BROERING, DEBORAH LUBECK, JAMES M. HENNING, SCOTT C. FLANDERS, and PETER R. CARROLL THERESA M. KOPPIETHERESA M. KOPPIE More articles by this author , GARY D. GROSSFELDGARY D. GROSSFELD More articles by this author , DAVID MILLERDAVID MILLER More articles by this author , JENNY YUJENNY YU More articles by this author , DAVID STIERDAVID STIER More articles by this author , JEANETTE M. BROERINGJEANETTE M. BROERING More articles by this author , DEBORAH LUBECKDEBORAH LUBECK More articles by this author , JAMES M. HENNINGJAMES M. HENNING More articles by this author , SCOTT C. FLANDERSSCOTT C. FLANDERS More articles by this author , and PETER R. CARROLLPETER R. CARROLL More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)67454-XAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We determined the demographic and clinical profile of men who elect surveillance as the initial management of prostate cancer as well as the incidence and predictors of secondary treatment of these patients. Materials and Methods: The Cancer of the Prostate Strategic Urological Research Endeavor (CaPSURE) is a national disease registry of patients with various stages and treatments of prostate cancer. Using this database of 4,458 men we identified 329 (8.2%) who elected surveillance as the initial management of prostate cancer. Patients choosing watchful waiting were compared to other CaPSURE participants using the chi-square test. The likelihood of treatment initiation in the watchful waiting group was calculated using the Kaplan-Meier method. After adjusting for patient age, race, prostate specific antigen (PSA) at diagnosis, clinical T stage and total Gleason score the Cox proportional hazards regression model was used to determine significant predictors of treatment initiation. Results: Compared with others in the database, patients on watchful waiting were more likely to be 75 years old or older (51% versus 16%, p <0.001), white (93% versus 85%, p <0.001), and have lower serum PSA (p <0.001), organ confined disease (97% versus 88%, p <0.001) and a total Gleason score of 7 or less (97% versus 88%, p <0.001). In the watchful waiting group there was a 52% likelihood of treatment initiation within 5 years of the diagnosis. Significant predictors of secondary treatment were age younger than 65 years and elevated serum PSA at diagnosis. Neither race, extraprostatic stage cT3 disease nor higher total Gleason score was a significant predictor of treatment. Conclusions: Men who elect initial watchful waiting for prostate cancer tend to be older, have lower serum PSA and more favorable disease characteristics than those who seek treatment. PSA at diagnosis is the dominant factor for predicting secondary treatment. References 1 : Cancer statistics, 1998. CA Cancer J Clin1998; 48: 6. Crossref, Medline, Google Scholar 2 : Fifteen-year survival in prostate cancer. A prospective, population-based study in Sweden. JAMA1997; 277: 467. Google Scholar 3 : Results of conservative management of clinically localized prostate cancer. New Engl J Med1994; 330: 242. Crossref, Medline, Google Scholar 4 : Long-term survival among men with conservatively treated localized prostate cancer. JAMA1995; 274: 626. Crossref, Medline, Google Scholar 5 : Deferred treatment in clinically localized prostatic carcinoma. Br J Urol1992; 69: 183. 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Prostate specific antigen doubling times and clinical behavior in patients with early untreated prostate carcinoma. Cancer1998; 82: 342. Google Scholar 13 : Follow-up prostate cancer treatments after radical prostatectomy: a population-based study. J Natl Cancer Inst1996; 88: 166. Google Scholar 14 : Patient-reported complications and follow-up treatment after radical prostatectomy. The national Medicare experience: 1988–1990 (updated June 1993). Urology1993; 42: 622. Crossref, Medline, Google Scholar 15 : Patient preferences for management of localized prostate cancer. West J Med1996; 165: 26. Google Scholar 16 : Prostate cancer screening and beliefs about treatment efficacy: a national survey of primary care physicians and urologists. Am J Med1998; 104: 526. Google Scholar From the Department of Urology, Center for Urologic Outcomes, University of California-San Francisco, University of California-San Francisco-Mt. Zion Cancer Center and Lewin TAG, San Francisco, California, and TAP Holdings, Deerfield, Illinois© 2000 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byMarks L (2015) Significance of Change in Gleason Grade in Patients on Active Surveillance for Prostate CancerJournal of Urology, VOL. 194, NO. 1, (8-9), Online publication date: 1-Jul-2015.Kasperzyk J, Shappley W, Kenfield S, Mucci L, Kurth T, Ma J, Stampfer M and Sanda M (2011) Watchful Waiting and Quality of Life Among Prostate Cancer Survivors in the Physicians' Health StudyJournal of Urology, VOL. 186, NO. 5, (1862-1867), Online publication date: 1-Nov-2011.ORNISH D, WEIDNER G, FAIR W, MARLIN R, PETTENGILL E, RAISIN C, DUNN-EMKE S, CRUTCHFIELD L, JACOBS F, BARNARD R, ARONSON W, McCORMAC P, McKNIGHT D, FEIN J, DNISTRIAN A, WEINSTEIN J, NGO T, MENDELL N and CARROLL P (2018) INTENSIVE LIFESTYLE CHANGES MAY AFFECT THE PROGRESSION OF PROSTATE CANCERJournal of Urology, VOL. 174, NO. 3, (1065-1070), Online publication date: 1-Sep-2005.IVERSEN P, JOHANSSON J, LODDING P, LUKKARINEN O, LUNDMO P, KLARSKOV P, TAMMELA T, TASDEMIR I, MORRIS T and CARROLL K (2018) BICALUTAMIDE (150 MG) VERSUS PLACEBO AS IMMEDIATE THERAPY ALONE OR AS ADJUVANT TO THERAPY WITH CURATIVE INTENT FOR EARLY NONMETASTATIC PROSTATE CANCER: 5.3-YEAR MEDIAN FOLLOWUP FROM THE SCANDINAVIAN PROSTATE CANCER GROUP STUDY NUMBER 6Journal of Urology, VOL. 172, NO. 5, (1871-1876), Online publication date: 1-Nov-2004.COOPERBERG M, BROERING J, LITWIN M, LUBECK D, MEHTA S, HENNING J and CARROLL P (2018) THE CONTEMPORARY MANAGEMENT OF PROSTATE CANCER IN THE UNITED STATES: LESSONS FROM THE CANCER OF THE PROSTATE STRATEGIC UROLOGIC RESEARCH ENDEAVOR (CAPSURE), A NATIONAL DISEASE REGISTRYJournal of Urology, VOL. 171, NO. 4, (1393-1401), Online publication date: 1-Apr-2004.WU H, SUN L, MOUL J, WU H, McLEOD D, AMLING C, LANCE R, KUSUDA L, DONAHUE T, FOLEY J, CHUNG A, SEXTON W and SODERDAHL D (2018) Watchful Waiting and Factors Predictive of Secondary Treatment of Localized Prostate CancerJournal of Urology, VOL. 171, NO. 3, (1111-1116), Online publication date: 1-Mar-2004.MENG M, ELKIN E, HARLAN S, MEHTA S, LUBECK D and CARROLL P (2018) Predictors of Treatment After Initial Surveillance in Men With Prostate Cancer: Results From CaPSUREJournal of Urology, VOL. 170, NO. 6, (2279-2283), Online publication date: 1-Dec-2003.HARLAN S, COOPERBERG M, ELKIN E, LUBECK D, MENG M, MEHTA S and CARROLL P (2018) Time Trends and Characteristics of Men Choosing Watchful Waiting for Initial Treatment of Localized Prostate Cancer: Results From CaPSUREJournal of Urology, VOL. 170, NO. 5, (1804-1807), Online publication date: 1-Nov-2003.ZIETMAN A, THAKRAL H, WILSON L and SCHELLHAMMER P (2018) CONSERVATIVE MANAGEMENT OF PROSTATE CANCER IN THE PROSTATE SPECIFIC ANTIGEN ERA: THE INCIDENCE AND TIME COURSE OF SUBSEQUENT THERAPYJournal of Urology, VOL. 166, NO. 5, (1702-1706), Online publication date: 1-Nov-2001. Volume 164Issue 1July 2000Page: 81-88 Advertisement Copyright & Permissions© 2000 by American Urological Association, Inc.Keywordsprostateprostate-specific antigenprostatic neoplasmsMetricsAuthor Information THERESA M. KOPPIE More articles by this author GARY D. GROSSFELD More articles by this author DAVID MILLER More articles by this author JENNY YU More articles by this author DAVID STIER More articles by this author JEANETTE M. BROERING More articles by this author DEBORAH LUBECK More articles by this author JAMES M. HENNING More articles by this author SCOTT C. FLANDERS More articles by this author PETER R. CARROLL More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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