MP38-14 UNITED STATES INSTITUTIONAL VARIATION IN THE USE OF ACTIVE SURVEILLANCE FOR LOW-RISK PROSTATE CANCER

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You have accessJournal of UrologyCME1 Apr 2023MP38-14 UNITED STATES INSTITUTIONAL VARIATION IN THE USE OF ACTIVE SURVEILLANCE FOR LOW-RISK PROSTATE CANCER Shu Wang, Amir Khan, Kathryn Hughes Barry, Michael Naslund, and M. Minhaj Siddiqui Shu WangShu Wang More articles by this author , Amir KhanAmir Khan More articles by this author , Kathryn Hughes BarryKathryn Hughes Barry More articles by this author , Michael NaslundMichael Naslund More articles by this author , and M. Minhaj SiddiquiM. Minhaj Siddiqui More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003276.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Active surveillance (AS) has been recommended as the initial management for low-risk prostate cancer (PCa). Even though we have witnessed a dramatic increase in the use of AS recently, significant variation still exists. This study aimed to investigate the use of AS for low-risk prostate cancer at the institutional level. METHODS: The National Cancer Database was used to identify patients diagnosed with low-risk prostate adenocarcinoma (NCCN criteria: cT1-cT2a, PSA<10, Gleason Score 3+3) as the only malignancy from 2015 to 2019. Patients aged 40-75 were included. Information on the initial management was accessed. The AS rate on the institute level was calculated as the number of patients on AS divided by the total number of patients with low-risk PCa reported by a specific institute. We only included institutions with a cohort of no less than ten patients. RESULTS: 1,010 institutions with 85,026 low-risk PCa patients were included in this study. The mean AS rates on the institutional level were 38% (IQR 15-55%), 36% (IQR 8-63%), 27% (IQR 5-44%), and 26% (IQR 3-45%), among Academic/Research Programs, Community Cancer Programs, Integrated Network Cancer Programs, and Comprehensive Community Cancer Programs, respectively (p<0.001). When stratifying centers based on the AS uptake rates, we found that 35% (350/1010) of institutions reported a very low AS rate (<10%), 28% (287/1010) reported a low AS rate (10-40%), 33% reported a suboptimal AS rate (40-80%) and only 4% achieved an optimal AS rate (>80%). The percentages of each institutional type stratified by AS rates are shown in Figure 1. Comprehensive Community Cancer Programs had the highest percentage (42%) of institutions with very low AS rates, and Community Cancer Programs had the highest percentage meeting an optimal AS rate (10%). CONCLUSIONS: Significant variations of AS for low-risk PCa were observed at the institutional level. A substantial number of institutions still demonstrate very low rates of <10% of AS for management of low-risk PCa. Source of Funding: N/A © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e529 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Shu Wang More articles by this author Amir Khan More articles by this author Kathryn Hughes Barry More articles by this author Michael Naslund More articles by this author M. Minhaj Siddiqui More articles by this author Expand All Advertisement PDF downloadLoading ...