San Diego, CA USA (UroToday.com) Active surveillance is a common treatment modality for very low, low, and low-intermediate risk prostate cancer; however, significant variation remains in its application for individual patients. As of now, the published guidelines are overly generalized, causing increased disparity in physician interpretation.
In this study, Dr. Cher and colleagues assessed the appropriateness of AS for very low to low-intermediate risk prostate cancer.
For this study, the authors created 160 individual clinical scenarios, each with a unique combination of parameters (Gleason score, PSA density, etc.) designed to influence physician decision-making. A panel of thirteen urologists from practices throughout the state was recruited to evaluate these clinical scenarios. Each member of the panel evaluated and scored the scenarios on two separate occasions, the first time in private and the second following a round of discussion amongst the panelists.
After review, none of the 160 clinical scenarios of very low, low, and low-intermediate risk prostate cancer were deemed “inappropriate” for AS. Although low volume Gleason 7 was deemed “uncertain,” none of the intermediate and high volume Gleason 6 were categorized as “inappropriate” for AS. Overall, this study underlines the changing mindset among practicing urologists with regards to AS, as it becomes a more favorable treatment modality.
Presented By: Michael Cher, MD
Written By: Austin Drysch; Department of Urology, University of California, Irvine at the 2016 AUA Annual Meeting - May 6 - 10, 2016 – San Diego, California, USA