MP12-13 SURVEILLANCE RATES FOR FAVORABLE INTERMEDIATE AND LOW RISK PROSTATE CANCER

Abstract

INTRODUCTION AND OBJECTIVE: The National Comprehensive Cancer Network (NCCN) guidelines recommend active surveillance (AS) as the preferred management of low risk (LR) prostate cancer (PCa) and an option for those with favorable intermediate risk (FIR) PCa. We hypothesized management trends would show AS increasing for men with LR and FIR PCa. This study describes trends in surveillance for LR and FIR PCa using the National Cancer Database (NCDB), which includes ∼50% of new PCa diagnoses in the United States per year. METHODS: NCDB was queried for all patients with LR and FIR localized PCa (2010-2015). LR and FIR were defined using 2019 NCCN guidelines for PCa. Staging was assigned using 2018 American Joint Committee on Cancer guidelines. Patients refusing treatment, unable to be treated due to comorbidity or with unknown treatment status were excluded. Men were grouped based on NCDB codes for initial surveillance. Surveillance rates were compared in between groups. Patient characteristics were compared between groups using chi squared test for categorical variables and t test for continuous variables. RESULTS: 132,409 LR and 8,093 FIR patients were identified. Of these patients 19,258 (14.5%) underwent surveillance in the LR group versus 396 (4.6%) in the FIR group. Surveillance rates increased for LR patients from 8% in 2010 to 28% in 2015 while rates in the FIR group increased from 3% to 7% (Figure 1). FIR patients undergoing surveillance were older (mean age 67.5 vs 64.1) and had a higher rate of Medicare coverage than the LR cohort (52.8% vs 41.5%, p<0.001) (Table 1). CONCLUSIONS: Surveillance rates for LR and FIR risk PCa remain low. As data matures for surveillance in the FIR population these rates will likely rise. This data provides baseline surveillance rates prior to the incorporation of surveillance for FIR patients into the NCCN guidelines. Further analysis in more contemporary cohorts once data is available will shed light on guideline adoption.Source of Funding: None