Does the multidisciplinary approach improve oncological outcomes in men undergoing surgical treatment for prostate cancer?

Suzanne B. Stewart, Judd W. Moul, Thomas J. Polascik, Bridget F. Koontz, Cary N. Robertson, Stephen J. Freedland, Daniel J. George, W. Robert Lee, Andrew J. Armstrong, Lionel L. Bañez

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Objectives: To determine whether oncological outcomes are improved in prostate cancer patients by using a multidisciplinary strategy as compared with a standard clinic paradigm, and whether time to treatment is delayed when using a multidisciplinary approach. Methods: We retrospectively analyzed patients who were evaluated and pursued radical prostatectomy as primary treatment, by the same surgeons, in the prostate cancer multidisciplinary clinic (n=194) and standard urology clinic (n=741) at Duke University Medical Center from 2005 to 2009. Comparisons of baseline characteristics were examined using rank sum and χ2-tests. Differences in time to radical prostatectomy and oncological outcomes were evaluated using multivariate linear and Cox regression, respectively. Results: A greater proportion of high-risk patients (D'Amico criteria) were evaluated at the multidisciplinary clinic compared with the urology clinic (23.2% vs 15.6%, P=0.014). Mean-adjusted time from biopsy to radical prostatectomy was shorter for multidisciplinary clinic patients (85.6 vs 96.8 days, P=0.006). After a median follow up of 21 months, no significant difference was found between the multidisciplinary clinic and urology clinic in the risk of biochemical recurrence after radical prostatectomy, whether controlling for clinical (hazard ratio 0.71, P=0.249) or pathological variables (hazard ratio 0.75, P=0.349). Conclusions: Despite higher-risk disease, men evaluated using the multidisciplinary approach have similar oncological outcomes compared with men undergoing standard evaluation. Furthermore, time to radical prostatectomy is not delayed by the multidisciplinary management of these patients.

Original languageEnglish (US)
Pages (from-to)1215-1219
Number of pages5
JournalInternational Journal of Urology
Volume21
Issue number12
DOIs
StatePublished - Dec 1 2014

All Science Journal Classification (ASJC) codes

  • Urology

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