PD13-11 TREATMENT IN THE ABSENCE OF DISEASE RECLASSIFICATION AMONG MEN ON ACTIVE SURVEILLANCE FOR PROSTATE CANCER

Abstract

You have accessJournal of UrologyProstate Cancer: Epidemiology & Natural History I (PD13)1 Sep 2021PD13-11 TREATMENT IN THE ABSENCE OF DISEASE RECLASSIFICATION AMONG MEN ON ACTIVE SURVEILLANCE FOR PROSTATE CANCER Peter Kirk, Lisa Newcomb, Kehao Zhu, Yingye Zheng, Jeannette Schenk, Daniel Lin, and John Gore Peter KirkPeter Kirk More articles by this author , Lisa NewcombLisa Newcomb More articles by this author , Kehao ZhuKehao Zhu More articles by this author , Yingye ZhengYingye Zheng More articles by this author , Jeannette SchenkJeannette Schenk More articles by this author , Daniel LinDaniel Lin More articles by this author , and John GoreJohn Gore More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001989.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Maintaining men on active surveillance (AS) for prostate cancer can be challenging. Although most men who eventually undergo treatment have experienced clinical progression, a smaller subset elects treatment in the absence of disease reclassification. We sought to better understand factors associated with treatment in a large, contemporary, prospective AS cohort. METHODS: We identified 1,789 men in the Canary Prostate Cancer Active Surveillance Study cohort enrolled as of 2020 with a median follow-up of 5.6 (IQR: 2.5-8.6) years. Clinical and demographics data as well as information for patient-reported quality of life and urinary symptoms were used in multivariable Cox proportional hazards regression models to identify factors independently associated with time to treatment, both overall and in the absence of biopsy grade reclassification. RESULTS: Within 4 years of diagnosis, 33% (95% CI 30-35) of men underwent treatment, and 10% (95% CI: 9-12) were treated in the absence of reclassification. The most significant factor associated with any treatment was increasing Gleason grade group (adjusted HR 14.5, 95% CI 11.7-17.9). Urinary quality of life scores were associated with treatment without reclassification (aHR 2.65, 95% CI 1.54-4.59, Table). In a subset analysis (N=692), married men were significantly more likely to undergo treatment in the absence of reclassification (aHR 0.37, 95% CI 0.14-0.94 for single men versus married men). CONCLUSIONS: A substantial number of men with prostate cancer undergo treatment in the absence of reclassification, and quality of life changes and marital status may be important factors in these decisions. Targeted interventions to manage quality of life changes that may not reflect cancer-specific changes such as urinary symptom progression, and involvement of spouses as key stakeholders in decision-making may reduce treatment in the absence of reclassification in some men. Source of Funding: Lisa Newcomb: 1 U01 CA224255 © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e213-e214 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Peter Kirk More articles by this author Lisa Newcomb More articles by this author Kehao Zhu More articles by this author Yingye Zheng More articles by this author Jeannette Schenk More articles by this author Daniel Lin More articles by this author John Gore More articles by this author Expand All Advertisement Loading ...