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A comparative assessment of active surveillance for localized prostate cancer in the community versus tertiary care referral center

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A comparative assessment of active surveillance for localized prostate cancer in the community versus tertiary care referral center. / Becker, Andreas; Seiler, Daniel; Kwiatkowski, Maciej; Kluth, Luis Alex; Schnell, Dietrich; Graefen, Markus; Schlomm, Thorsten; Fisch, Margit; Recker, Franz; Weissbach, Lothar; Chun, Felix K H.

In: WORLD J UROL, Vol. 32, No. 4, 01.08.2014, p. 891-897.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Becker, A, Seiler, D, Kwiatkowski, M, Kluth, LA, Schnell, D, Graefen, M, Schlomm, T, Fisch, M, Recker, F, Weissbach, L & Chun, FKH 2014, 'A comparative assessment of active surveillance for localized prostate cancer in the community versus tertiary care referral center', WORLD J UROL, vol. 32, no. 4, pp. 891-897. https://doi.org/10.1007/s00345-014-1309-2

APA

Becker, A., Seiler, D., Kwiatkowski, M., Kluth, L. A., Schnell, D., Graefen, M., Schlomm, T., Fisch, M., Recker, F., Weissbach, L., & Chun, F. K. H. (2014). A comparative assessment of active surveillance for localized prostate cancer in the community versus tertiary care referral center. WORLD J UROL, 32(4), 891-897. https://doi.org/10.1007/s00345-014-1309-2

Vancouver

Becker A, Seiler D, Kwiatkowski M, Kluth LA, Schnell D, Graefen M et al. A comparative assessment of active surveillance for localized prostate cancer in the community versus tertiary care referral center. WORLD J UROL. 2014 Aug 1;32(4):891-897. https://doi.org/10.1007/s00345-014-1309-2

Bibtex

@article{c81f163aae40413d98cdcab98868f6b0,
title = "A comparative assessment of active surveillance for localized prostate cancer in the community versus tertiary care referral center",
abstract = "OBJECTIVES: To date, evidence on active surveillance (AS) is restricted to protocol-based studies. Conversely, practice patterns outside of such protocols are unknown. The aim of this study was to capture the current AS treatment patterns for localized prostate cancer in patients managed by office-based urologists compared to patients treated at a tertiary care center.METHODS AND MATERIALS: Two prospective cohorts were investigated: 361 AS arm patients of the German Hormonal treatment, Active surveillance, Radiation therapy, OP, Watchful waiting (HAROW) study, an observational health service study and 387 protocol-based AS patients treated at the Department of Urology of the Kantonsspital Aarau, Switzerland were included. Observational non-protocol HAROW versus on-protocol Kantonsspital Aarau (KSA) was compared, and active-treatment-free survival represented the primary outcome.RESULTS: Study population of the observational HAROW versus tertiary care protocol-based KSA cohorts differed statistically significantly regarding age (p < 0.001) and proportion of patients meeting the Chism criteria (p < 0.001). In stratified analyses, AFTS at 1 and 2 years was, respectively, 87.7 % (95 % CI 84.0-91.7) and 75.0 % (95 % CI 69.7-80.8) in HAROW patients compared to 90.8 % (95 % CI 87.8-93.9) and 75.3 % (95 % CI 70.7-80.1) for patients in the KSA cohort (p = 0.97).CONCLUSION: We demonstrate significant differences in terms of AS inclusion, surveillance and discontinuation criteria between patients managed by office-based urologists compared to their tertiary care counterparts. Interestingly, the risk of deferred active therapy was equally moderate for both groups in the short-term follow-up.",
author = "Andreas Becker and Daniel Seiler and Maciej Kwiatkowski and Kluth, {Luis Alex} and Dietrich Schnell and Markus Graefen and Thorsten Schlomm and Margit Fisch and Franz Recker and Lothar Weissbach and Chun, {Felix K H}",
year = "2014",
month = aug,
day = "1",
doi = "10.1007/s00345-014-1309-2",
language = "English",
volume = "32",
pages = "891--897",
journal = "WORLD J UROL",
issn = "0724-4983",
publisher = "Springer",
number = "4",

}

RIS

TY - JOUR

T1 - A comparative assessment of active surveillance for localized prostate cancer in the community versus tertiary care referral center

AU - Becker, Andreas

AU - Seiler, Daniel

AU - Kwiatkowski, Maciej

AU - Kluth, Luis Alex

AU - Schnell, Dietrich

AU - Graefen, Markus

AU - Schlomm, Thorsten

AU - Fisch, Margit

AU - Recker, Franz

AU - Weissbach, Lothar

AU - Chun, Felix K H

PY - 2014/8/1

Y1 - 2014/8/1

N2 - OBJECTIVES: To date, evidence on active surveillance (AS) is restricted to protocol-based studies. Conversely, practice patterns outside of such protocols are unknown. The aim of this study was to capture the current AS treatment patterns for localized prostate cancer in patients managed by office-based urologists compared to patients treated at a tertiary care center.METHODS AND MATERIALS: Two prospective cohorts were investigated: 361 AS arm patients of the German Hormonal treatment, Active surveillance, Radiation therapy, OP, Watchful waiting (HAROW) study, an observational health service study and 387 protocol-based AS patients treated at the Department of Urology of the Kantonsspital Aarau, Switzerland were included. Observational non-protocol HAROW versus on-protocol Kantonsspital Aarau (KSA) was compared, and active-treatment-free survival represented the primary outcome.RESULTS: Study population of the observational HAROW versus tertiary care protocol-based KSA cohorts differed statistically significantly regarding age (p < 0.001) and proportion of patients meeting the Chism criteria (p < 0.001). In stratified analyses, AFTS at 1 and 2 years was, respectively, 87.7 % (95 % CI 84.0-91.7) and 75.0 % (95 % CI 69.7-80.8) in HAROW patients compared to 90.8 % (95 % CI 87.8-93.9) and 75.3 % (95 % CI 70.7-80.1) for patients in the KSA cohort (p = 0.97).CONCLUSION: We demonstrate significant differences in terms of AS inclusion, surveillance and discontinuation criteria between patients managed by office-based urologists compared to their tertiary care counterparts. Interestingly, the risk of deferred active therapy was equally moderate for both groups in the short-term follow-up.

AB - OBJECTIVES: To date, evidence on active surveillance (AS) is restricted to protocol-based studies. Conversely, practice patterns outside of such protocols are unknown. The aim of this study was to capture the current AS treatment patterns for localized prostate cancer in patients managed by office-based urologists compared to patients treated at a tertiary care center.METHODS AND MATERIALS: Two prospective cohorts were investigated: 361 AS arm patients of the German Hormonal treatment, Active surveillance, Radiation therapy, OP, Watchful waiting (HAROW) study, an observational health service study and 387 protocol-based AS patients treated at the Department of Urology of the Kantonsspital Aarau, Switzerland were included. Observational non-protocol HAROW versus on-protocol Kantonsspital Aarau (KSA) was compared, and active-treatment-free survival represented the primary outcome.RESULTS: Study population of the observational HAROW versus tertiary care protocol-based KSA cohorts differed statistically significantly regarding age (p < 0.001) and proportion of patients meeting the Chism criteria (p < 0.001). In stratified analyses, AFTS at 1 and 2 years was, respectively, 87.7 % (95 % CI 84.0-91.7) and 75.0 % (95 % CI 69.7-80.8) in HAROW patients compared to 90.8 % (95 % CI 87.8-93.9) and 75.3 % (95 % CI 70.7-80.1) for patients in the KSA cohort (p = 0.97).CONCLUSION: We demonstrate significant differences in terms of AS inclusion, surveillance and discontinuation criteria between patients managed by office-based urologists compared to their tertiary care counterparts. Interestingly, the risk of deferred active therapy was equally moderate for both groups in the short-term follow-up.

U2 - 10.1007/s00345-014-1309-2

DO - 10.1007/s00345-014-1309-2

M3 - SCORING: Journal article

C2 - 24820259

VL - 32

SP - 891

EP - 897

JO - WORLD J UROL

JF - WORLD J UROL

SN - 0724-4983

IS - 4

ER -