Methods: MUSIC maintains a prospective registry of PC patients from 44 academic and community urology practices within the state of Michigan. The authors identified all patients in the registry managed with AS from 2011-2015. LTFU was defined as any 18-month period where no pertinent surveillance information was identified in the medical record by trained data abstractors (i.e., no PSA, prostate CT/MRI, or prostate biopsy). LTFU events were stratified as either (1) prolonged loss to follow up (PLTFU): a LTFU event with no further data entered. Lastly, the authors fit a multivariable logistic regression models and compared adjusted rates of LTFU events across MUSIC practices.
Results: Out of the 2211 men enrolled on AS from 2011-2015, 217 (9.8%) had a LTFU event. Of these, 184 (8.3%) patients had PLTFU and 33 (1.5%) had IFU. African American (AA) patients were more likely than Caucasian patients to be LTFU (17.0% vs 7.4%, p<0.05). In multivariable analyses, both AA race (OR 2.29, 95% CI 1.38-3.82) and Charlson comorbidity index (CCI) of 1 or more (OR 1.75, 95% CI 1.10-2.76) were independently associated with an increased likelihood of LTFU.
Conclusion: Nearly ten percent of men placed on AS become LTFU, representing suboptimal implementation of this management strategy. Patient-specific factors associated with being LTFU include AA race and a greater rate of medical comorbidities. The authors state it is important to find the factors causing lower LFTU rates and implement them in a systematic way.
Presented by: Kevin Benjamin Ginsburg, Wayne State University Department of Urology, Detroit, MI, USA
Written by: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre, @GoldbergHanan, at the 18th Annual Meeting of the Society of Urologic Oncology, November 29-December 1, 2017 – Washington, DC