Active Surveillance as Initial Management of Newly Diagnosed Prostate Cancer

Data from the PURC

Mahesh Botejue, Daniel Abbott, John Danella, Claudette Fonshell, Serge Ginzburg, Thomas J. Guzzo, Thomas Lanchoney, Bret Marlowe, Jay Raman, Marc Smaldone, Jeffrey J. Tomaszewski, Edouard J. Trabulsi, Robert G. Uzzo, Adam C. Reese

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Purpose:We describe contemporary active surveillance utilization and variation in a regional prostate cancer collaborative. We identified demographic and disease specific factors associated with active surveillance in men with newly diagnosed prostate cancer.Materials and Methods:We analyzed data from the PURC (Pennsylvania Urologic Regional Collaborative), a cooperative effort of urology practices in southeastern Pennsylvania and New Jersey. We determined the rates of active surveillance among men with newly diagnosed NCCN® (National Comprehensive Cancer Network®) very low, low or intermediate prostate cancer and compared the rates among participating practices and providers. Univariate and multivariable analyses were used to identify factors associated with active surveillance utilization.Results:A total of 1,880 men met inclusion criteria. Of the men with NCCN very low or low risk prostate cancer 57.4% underwent active surveillance as the initial management strategy. Increasing age was significantly associated with active surveillance (p <0.001) while adverse clinicopathological variables were associated with decreased active surveillance use. Substantial variation in active surveillance utilization was observed among practices and providers.Conclusions:More than 50% of men with low risk disease in the PURC collaborative were treated with active surveillance. However, substantial variation in active surveillance rates were observed among practices and providers in academic and community settings. Advanced age and favorable clinicopathological factors were strongly associated with active surveillance. Analysis of regional collaboratives such as the PURC may allow for the development of strategies to better standardize treatment in men with prostate cancer and offer active surveillance in a more uniform and systematic fashion.

Original languageEnglish (US)
Pages (from-to)929-935
Number of pages7
JournalJournal of Urology
Volume201
Issue number5
DOIs
StatePublished - May 1 2019

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Prostatic Neoplasms
Urology
Neoplasms
Demography
Therapeutics

All Science Journal Classification (ASJC) codes

  • Urology

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Botejue, M., Abbott, D., Danella, J., Fonshell, C., Ginzburg, S., Guzzo, T. J., ... Reese, A. C. (2019). Active Surveillance as Initial Management of Newly Diagnosed Prostate Cancer: Data from the PURC. Journal of Urology, 201(5), 929-935. https://doi.org/10.1016/j.juro.2018.10.018
Botejue, Mahesh ; Abbott, Daniel ; Danella, John ; Fonshell, Claudette ; Ginzburg, Serge ; Guzzo, Thomas J. ; Lanchoney, Thomas ; Marlowe, Bret ; Raman, Jay ; Smaldone, Marc ; Tomaszewski, Jeffrey J. ; Trabulsi, Edouard J. ; Uzzo, Robert G. ; Reese, Adam C. / Active Surveillance as Initial Management of Newly Diagnosed Prostate Cancer : Data from the PURC. In: Journal of Urology. 2019 ; Vol. 201, No. 5. pp. 929-935.
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abstract = "Purpose:We describe contemporary active surveillance utilization and variation in a regional prostate cancer collaborative. We identified demographic and disease specific factors associated with active surveillance in men with newly diagnosed prostate cancer.Materials and Methods:We analyzed data from the PURC (Pennsylvania Urologic Regional Collaborative), a cooperative effort of urology practices in southeastern Pennsylvania and New Jersey. We determined the rates of active surveillance among men with newly diagnosed NCCN{\circledR} (National Comprehensive Cancer Network{\circledR}) very low, low or intermediate prostate cancer and compared the rates among participating practices and providers. Univariate and multivariable analyses were used to identify factors associated with active surveillance utilization.Results:A total of 1,880 men met inclusion criteria. Of the men with NCCN very low or low risk prostate cancer 57.4{\%} underwent active surveillance as the initial management strategy. Increasing age was significantly associated with active surveillance (p <0.001) while adverse clinicopathological variables were associated with decreased active surveillance use. Substantial variation in active surveillance utilization was observed among practices and providers.Conclusions:More than 50{\%} of men with low risk disease in the PURC collaborative were treated with active surveillance. However, substantial variation in active surveillance rates were observed among practices and providers in academic and community settings. Advanced age and favorable clinicopathological factors were strongly associated with active surveillance. Analysis of regional collaboratives such as the PURC may allow for the development of strategies to better standardize treatment in men with prostate cancer and offer active surveillance in a more uniform and systematic fashion.",
author = "Mahesh Botejue and Daniel Abbott and John Danella and Claudette Fonshell and Serge Ginzburg and Guzzo, {Thomas J.} and Thomas Lanchoney and Bret Marlowe and Jay Raman and Marc Smaldone and Tomaszewski, {Jeffrey J.} and Trabulsi, {Edouard J.} and Uzzo, {Robert G.} and Reese, {Adam C.}",
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Botejue, M, Abbott, D, Danella, J, Fonshell, C, Ginzburg, S, Guzzo, TJ, Lanchoney, T, Marlowe, B, Raman, J, Smaldone, M, Tomaszewski, JJ, Trabulsi, EJ, Uzzo, RG & Reese, AC 2019, 'Active Surveillance as Initial Management of Newly Diagnosed Prostate Cancer: Data from the PURC', Journal of Urology, vol. 201, no. 5, pp. 929-935. https://doi.org/10.1016/j.juro.2018.10.018

Active Surveillance as Initial Management of Newly Diagnosed Prostate Cancer : Data from the PURC. / Botejue, Mahesh; Abbott, Daniel; Danella, John; Fonshell, Claudette; Ginzburg, Serge; Guzzo, Thomas J.; Lanchoney, Thomas; Marlowe, Bret; Raman, Jay; Smaldone, Marc; Tomaszewski, Jeffrey J.; Trabulsi, Edouard J.; Uzzo, Robert G.; Reese, Adam C.

In: Journal of Urology, Vol. 201, No. 5, 01.05.2019, p. 929-935.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Active Surveillance as Initial Management of Newly Diagnosed Prostate Cancer

T2 - Data from the PURC

AU - Botejue, Mahesh

AU - Abbott, Daniel

AU - Danella, John

AU - Fonshell, Claudette

AU - Ginzburg, Serge

AU - Guzzo, Thomas J.

AU - Lanchoney, Thomas

AU - Marlowe, Bret

AU - Raman, Jay

AU - Smaldone, Marc

AU - Tomaszewski, Jeffrey J.

AU - Trabulsi, Edouard J.

AU - Uzzo, Robert G.

AU - Reese, Adam C.

PY - 2019/5/1

Y1 - 2019/5/1

N2 - Purpose:We describe contemporary active surveillance utilization and variation in a regional prostate cancer collaborative. We identified demographic and disease specific factors associated with active surveillance in men with newly diagnosed prostate cancer.Materials and Methods:We analyzed data from the PURC (Pennsylvania Urologic Regional Collaborative), a cooperative effort of urology practices in southeastern Pennsylvania and New Jersey. We determined the rates of active surveillance among men with newly diagnosed NCCN® (National Comprehensive Cancer Network®) very low, low or intermediate prostate cancer and compared the rates among participating practices and providers. Univariate and multivariable analyses were used to identify factors associated with active surveillance utilization.Results:A total of 1,880 men met inclusion criteria. Of the men with NCCN very low or low risk prostate cancer 57.4% underwent active surveillance as the initial management strategy. Increasing age was significantly associated with active surveillance (p <0.001) while adverse clinicopathological variables were associated with decreased active surveillance use. Substantial variation in active surveillance utilization was observed among practices and providers.Conclusions:More than 50% of men with low risk disease in the PURC collaborative were treated with active surveillance. However, substantial variation in active surveillance rates were observed among practices and providers in academic and community settings. Advanced age and favorable clinicopathological factors were strongly associated with active surveillance. Analysis of regional collaboratives such as the PURC may allow for the development of strategies to better standardize treatment in men with prostate cancer and offer active surveillance in a more uniform and systematic fashion.

AB - Purpose:We describe contemporary active surveillance utilization and variation in a regional prostate cancer collaborative. We identified demographic and disease specific factors associated with active surveillance in men with newly diagnosed prostate cancer.Materials and Methods:We analyzed data from the PURC (Pennsylvania Urologic Regional Collaborative), a cooperative effort of urology practices in southeastern Pennsylvania and New Jersey. We determined the rates of active surveillance among men with newly diagnosed NCCN® (National Comprehensive Cancer Network®) very low, low or intermediate prostate cancer and compared the rates among participating practices and providers. Univariate and multivariable analyses were used to identify factors associated with active surveillance utilization.Results:A total of 1,880 men met inclusion criteria. Of the men with NCCN very low or low risk prostate cancer 57.4% underwent active surveillance as the initial management strategy. Increasing age was significantly associated with active surveillance (p <0.001) while adverse clinicopathological variables were associated with decreased active surveillance use. Substantial variation in active surveillance utilization was observed among practices and providers.Conclusions:More than 50% of men with low risk disease in the PURC collaborative were treated with active surveillance. However, substantial variation in active surveillance rates were observed among practices and providers in academic and community settings. Advanced age and favorable clinicopathological factors were strongly associated with active surveillance. Analysis of regional collaboratives such as the PURC may allow for the development of strategies to better standardize treatment in men with prostate cancer and offer active surveillance in a more uniform and systematic fashion.

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